International Archives of Otorhinolaryngology最新文献

Introduction: Cells in diabetes mellitus (DM) respond to low oxygen by increasing hypoxia-inducible factor-1 (HIF-1), which impacts vascular endothelial growth factor (VEGF). Although curcuminoids show therapeutic promise, no validated options are available to repair organ of Corti damage caused by DM.

Objective: The present study aims to evaluate the effects of curcuminoid administration on the signal-to-noise ratio (SNR) and plasma levels of HIF-1α and VEGF-A in a DM model using Rattus norvegicus .

Methods: An in vivo experimental design was employed with a double-blind control set up. Twenty-five male Wistar rats were divided into 5 groups: group 1 (DM without curcuminoids), groups 2 and 3 (DM with curcuminoids at 200 and 400 mg/kg body weight for 10 days), and groups 4 and 5 (DM with curcuminoids at 200 and 400 mg/kg body weight for 13 days). Diabetes mellitus was induced through an intraperitoneal injection of alloxan (150 mg/kg body weight). Distortion product otoacoustic emission (DPOAE) tests were performed. Enzyme-linked immunosorbent assay (ELISA) was used to measure plasma levels of HIF-1α and VEGF-A.

Results: Significant differences were observed in SNR values, HIF-1α, and VEGF-A ( p  < 0.05). A significant correlation was found between SNR and HIF-1α (r = - 0.553; p  = 0.004) and VEGF-A (r = - 0.564; p  = 0.003), indicating that lower levels of these factors were associated with higher SNR.

Conclusion: Curcuminoids can prevent and treat outer hair cell damage in the organ of Corti due to DM, as shown by improvements in plasma HIF-1α, VEGF-A levels, and SNR values.

Objective: To assess the quality of life in patients with unilateral otosclerosis treated surgically with stapedotomy. Both objective indicators (hearing thresholds and air-bone gap) and subjective patient assessment of quality of life were considered.

Methods: We included 84 patients with unilateral otosclerosis who underwent stapes surgery. There were 24 men and 60 women, aged between 22 and 73 (mean = 44.1 ± 10.5) years. Pure tone audiometry (frequency range: 0.125-8 kHz) was performed preoperatively and 6 and 12 months postoperatively. Quality of life was assessed with the Assessment of Quality of Life - 8 Dimensions (AQoL-8D) questionnaire.

Results: The preoperative air-conduction hearing thresholds were on average 56.6 dB HL and improved significantly to 31.3 dB HL 6 months after stapes surgery. Air-bone gap before surgery was on average 29.8 dB HL and improved significantly to 9.9 dB 6 months after stapes surgery. Hearing thresholds were stable for 12 months after stapes surgery. Overall quality of life significantly increased after surgery, with improvements occurring in several domains: independent living , senses , mental health , coping , and relationships .

Conclusion: Stapedotomy is an effective treatment for patients with unilateral otosclerosis. As well as improving hearing thresholds, it significantly enhances overall quality of life.

Introduction: Tinnitus is the perception of sound without an external source. Various treatments and therapeutic strategies for tinnitus have been used. More recently, this includes music therapy (MT), which aims to mask tinnitus using specific musical elements such as rhythm, melody, harmony, and tempo.

Objective: To identify evidence in the literature regarding the use of MT for the treatment of tinnitus, the techniques employed, and the outcomes achieved.

Data synthesis: In the present systematic review, we searched for articles in the PubMed, Scopus, Web of Science, MEDLINE, LILACS, and SciELO databases, up until January 2024. The search included articles published in English, Portuguese, and German. Articles on the use of MT for the treatment of tinnitus were included. Duplicates, literature reviews, case reports, letters, and editorials were excluded. The descriptors used were " music therapy ", " acoustic stimulation " and " tinnitus ". Random effects models using the restricted maximum likelihood method were used to estimate the proportion of patients with favorable outcomes. The seardescriptions resulted in the initial selection of 552 articles containing one or more descriptors in the article title. We selected 211 for abstract review, and 48 were selected for full-text review. Finally, 23 articles published between 2005 and 2022 were selected for meta-analysis.

Conclusion: As an effective method for the treatment of tinnitus, MT stimulates the peripheral and central auditory pathways as well as central para-auditory pathways (related to attention, concentration, memory, and emotions).

Introduction: Understanding surgical outcomes in diverse settings is crucial for safe delivery of healthcare to underserved communities. Insufficient research has been done analyzing postoperative complications in regions with limited access to healthcare resources.

Objective: To compare postoperative complications from tonsillectomies and adenoidectomies on global health trips to an underserved community to those of a tertiary academic medical center (TAMC).

Methods: Data was collected via phone survey with patients from 2 2023 surgical trips to Azua, in the Dominican Republic (DR), sponsored by a TAMC, including surgery type, postoperative healthcare visits, and postoperative complications. The same data was collected via retrospective chart review from patients at a TAMC in 2023. The surgeries included were tonsillectomy adenoidectomy (T&A), tonsillectomy (T), and adenoidectomy (A). A statistical analysis compared non-routine healthcare visits and postoperative complications between populations using the Fisher's exact test.

Results: In the DR, 168 patients (mean age: 8 years) underwent T&A (n = 113), T (n = 34), and A (n = 21). At the TAMC, 520 patients (mean age: 7.8 years) underwent T&A (n = 288), T (n = 123), and A (n = 109). No patients from the DR reported postoperative bleeding within 2 weeks of surgery, compared to 23 patients from the TAMC ( p  < 0.001). There was no statistical difference in trouble swallowing and uncontrolled pain within 2 weeks between the populations ( p  = 0.673 and 0.465).

Conclusion: The T&A procedures on global health trips to underserved communities were not associated with increased rates of life-threatening complications compared with a TAMC. Surgical trips can provide safe and effective otolaryngologic care to patients in underserved communities.

Introduction: Salivary gland tumors (SGTs) are uncommon lesions that account for 3 to 6% of head and neck cancers.

Objective: To investigate mismatch repair (MMR) proteins, tumor-infiltrating lymphocytes (TILs), and CD45RO expression in salivary gland tumors (SGTs).

Methods: Proteins MLH1, MSH2, MSH6, and PMS2 of the MMR proteins family and CD45RO were evaluated using immunohistochemistry (IHC). Hematoxylin and eosin-stained sections were scored to explore the rate of TILs.

Results: None of the malignant and benign SGTs had partial or complete loss of at least one of the MMR proteins. Mucoepidermoid carcinomas, adenoid cystic carcinomas, salivary ductal carcinomas, and acinic cell carcinomas as malignant tumor types, and pleomorphic adenoma and Warthin's tumors as the most common benign tumors showed considerable differences in terms of the infiltration of TILs and CD45RO. Malignant tumors exhibited a notable difference in the infiltration of CD45RO ⁺ cells compared to benign ones. Both the tumor, node, metastasis (TNM) stage and the histological grade were shown to be linked with the infiltration status of CD45RO ⁺ cells.

Conclusion: Our results show that MMR deficiency might be insignificant and less relevant in SGTs. However, differences in TIL rate and CD45RO expression indicate that each of the SGT tumor types may have distinguished immune microenvironments. Malignant SGTs have higher infiltration of activated immune cells, and, thereby, these cells can be considered as good indicators of patient's status.

Objective: To compare the performance of two types of supra-aural headphones in both silence and noise in automated hearing screening in adults via tablet computers.

Methods: Basic audiological assessments and audiometry screenings via tablet were conducted in silence and noise in 35 participants. The hearing screening application assesses frequencies of 1, 2, and 4 kHz (20 dBHL) and 0.5 kHz (30 dBHL) in each ear separately. Two different headphones were tested: TDH 39 (Telephonics Corporation) and Sennheiser HD 280 PRO (Sennheiser) (with passive noise cancellation)-in silence, white noise, and cafeteria noise, emitted in a free field. The screening results were compared with the gold standard (audiometry).

Results: The results of the 35 participants with Sennheiser HD 280 PRO were compatible with the gold standard in the 3 situations. With TDH 39, the results of 33 individuals in silence and 34 in white noise were compatible with the gold standard. Both headphones, in automated screening in silence and noise, had 100% sensitivity, more than 93% specificity, and more than 94% accuracy.

Conclusion: Both headphones performed well in the tablet automated hearing screening in the three situations. The HD 280 PRO performed better in silence and noise regarding specificity and accuracy. In cafeteria noise, there was no difference between the two headphones.

Introduction: The tongue is one of the most important organs in the swallowing process, since impaired tongue function can decrease swallowing effectiveness and safety. Therefore, assessing tongue function is essential to help determine and treat swallowing disorders.

Objectives: To assess tongue strength and endurance in healthy Brazilian adults and to analyze likely variations related to age range and sex.

Methods: In total, 219 individuals > 18 years old, equally divided into age groups (18 to 39 years old, 40 to 60 years old, and > 60 years old, each group comprising 73 individuals), were assessed using the Iowa Oral Performance Instrument (IOPI) to measure tongue strength and endurance.

Results: Tongue strength was significantly lower in older individuals (45.84 kilopascals [kPa]) than in the younger groups (54.16 kPa for young individuals and 54.36 kPa for middle-aged individuals). Similarly, tongue endurance was significantly lower in older individuals. Regarding sex, the assessed parameter only presented significant difference between men and women in the young adult group (men recorded tongue strength 10 kPa higher than that of women).

Conclusion: Normal values for tongue strength in the healthy Brazilian population were established. These values changed based on age group as older individuals presented lower tongue strength and endurance than younger ones. These results highlight the importance of taking age and sex into consideration when assessing tongue strength.

Introduction: Children with allergic rhinitis (AR) may develop comorbidities due to chronic inflammation affecting other systems. Surveillance, early detection, and prompt treatment are essential in managing these conditions.

Objectives: To investigate the prevalence and associated characteristics of ear, nose, and throat (ENT) disorders, particularly adenoid hypertrophy (AH), tonsillar hypertrophy (TH), otitis media with effusion (OME), and rhinosinusitis (RS) in children with AR. Also, to assess potential risk factors associated with these comorbidities.

Methods: A total of 100 children aged 2 to 14 years with AR were enrolled. All patients underwent history taking, physical examination, and lateral skull X-ray processes by a pediatric otorhinolaryngologist.

Results: There was a significantly higher incidence of TH in patients with moderate-to-severe persistent AR (54.5%) compared with those with mild intermittent AR (17.2%; p  = 0.006). Furthermore, AH was observed in 51.7% of children with mild intermittent AR, significantly more than in other severity groups ( p  = 0.037). The prevalence of TH, AH, OME, and RS was 41, 39, 8, and 1%, respectively. Additionally, OME was more common in suburban residents (14.3%) than in urban dwellers (2%; p  = 0.029). The most common aeroallergen was the house dust mite Dermatophagoides pteronyssinus (89%).

Conclusion: The most common ENT comorbidity in AR children is TH, being related substantially to the level of severity. The most prevalent aeroallergen was found to be house dust mite. The pattern of association between AR and ENT comorbidities highlights the essence of our research findings.

Introduction: Herpes Zoster Oticus is etiologically associated with the reactivation of the Varicella-Zoster virus in the geniculate ganglion. Its primary manifestation includes pain, vesicles in the external auditory canal, and peripheral facial paralysis. The prognosis of the syndrome remains under scrutiny and debate, fluctuating based on symptom severity and clinical manifestation. The scarcity of articles accurately correlating clinical presentation and prognosis, coupled with individual factors and the syndrome's rarity, constrains more comprehensive analyses.

Objectives: To conduct a systematic review to determine whether it is possible to predict the prognosis of RHS based on clinical factors.

Data synthesis: This study identified a total of 6,464 articles within the databases, which were subsequently evaluated by two independent researchers. Sixty-two articles underwent full-text examinations, and following meticulous selection criteria, twelve articles were ultimately incorporated into this study. Factors such as age, onset of House-Brackmann degree, dizziness, hearing loss, time to treatment initiation, and comorbidities appear to exert influence on prognosis. The articles exhibit methodological limitations and discrepancies among them, stemming from variations in prognostic concepts, treatment protocols, evaluation timing, or reported outcomes. These variations hinder the possibility of conducting a methodologically sound comparison, regardless of how closely aligned the trials are with the theme.

Conclusion: The review concludes that it is not possible to definitively assert the presence of a clinical parameter defining the prognosis in Herpes Zoster Oticus.