International Archives of Otorhinolaryngology最新文献

Introduction: Chronic obstructive pulmonary disease (COPD) affects lung function, but its impact on vocal function remains understudied.

Objective: To investigate the relationship involving COPD severity and vocal acoustic parameters and to assess the correlations regarding acoustic measures and pulmonary function tests in clinically stable COPD patients.

Methods: The present observational study included 40 COPD patients diagnosed according to the 2023 guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD). All patients underwent spirometry, an otorhinolaryngological examination, and acoustic voice analysis, including fundamental frequency (F0), harmonics-to-noise ratio (HNR), jitter, and shimmer. The Arabic version of the Voice-Related Quality of Life (V-RQOL) questionnaire was used to assess voice-related impairment.

Results: The sample had a mean age of 65 ± 6 years, with 92.5% of male subjects. Dysphonia was observed in 57.5% of the patients. Laryngoscopic findings included Reinke's edema (42.5%), laryngitis (25%), polypoid degeneration (20%), and phonasthenia (12.5%). The acoustic analysis revealed significant negative correlations involving pulmonary function parameters and vocal measures. The regression analysis demonstrated forced expiratory volume in the first second (FEV1) and FEV1/forced vital capacity (FVC) as significant predictors of mean pitch, jitter, and shimmer, with each unit increase in FEV1 associated with a decrease in these acoustic measures ( p  < 0.001).

Conclusion: The severity of COPD is significantly associated with acoustic voice alterations, with disease progression leading to measurable impairments in vocal function. These findings highlight the importance of voice assessment in COPD management.

Introduction: Preauricular defects is one of the main concerns after superficial parotidectomy. Plastic surgeons have described many filling techniques to overcome the problem.

Objective: To discuss and compare the esthetic and functional outcomes of three postsuperficial parotidectomy reconstruction techniques: partial-thickness, superiorly based sternocleidomastoid muscle flap, en-bloc fat grafting, and platelet-rich fibrin gel.

Methods: We included 29 adult patients submitted to reconstruction after superficial parotidectomy by partial-thickness, superiorly based sternocleidomastoid muscle flap, en-bloc fat grafting, and platelet-rich fibrin gel. A subjective evaluation of the overall facial appearance was conducted through a 5-point visual analog scale filled out by the patient, a close relative, and 3 blind staff members.

Results: Regarding the visual analog scale, in the comparison between the three groups (at the sixth and the twelfth months), the fat group reported the highest mean for satisfaction (3.4 ± 1.1 and 3.83 ± 0.97 respectively) and showed a highly-significant difference when compared to the sternocleidomastoid muscle flap and the platelet-rich fibrin gel groups ( p  = 0.0001 and 0.016 respectively).

Conclusion: Parotidectomy with immediate reconstruction of the surgical defect with an en-block fat graft provides better esthetic outcomes than sternocleidomastoid muscle flap and platelet-rich fibrin gel after 1 year. The sternocleidomastoid muscle flap and fat techniques resulted in minimal surgical-site morbidity and lower likelihood of developing Frey's syndrome. The fat graft yielded the best degree of cosmetic satisfaction with minimal morbidity. Fat overcorrection is recommended.Level of Evidence : 4.

Introduction: Tinnitus is a prevalent symptom and has no proven effective treatment. Clinical observations that some patients reported significantly improved tinnitus after topical ear drop administration of lidocaine motivated research on this drug.

Objective: Evaluate the action of topical intra-auricular 10% lidocaine in suppressing tinnitus compared to placebo.

Methods: This was a randomized, crossover, double-blind, placebo-controlled clinical trial. The variations of the visual analog scale (VAS), tinnitus loudness, and the minimum masking level (MML) after intra-auricular lidocaine 10% were compared with a placebo. The same variables were compared with some sample features.

Results: There was no statistically significant difference between the action of lidocaine and placebo in tinnitus variation measured by VAS (p = 0.361), tinnitus loudness (p = 0.850), and MML. (p = 0.213). The VAS variation was statistically lower in patients with any hearing loss (p = 0.005); the tinnitus loudness variation was higher in patients with tinnitus modulation (p = 0.049) and lower in patients with any hearing loss (p = 0.045). The MML variation was lower in patients with bruxism/TMD (p = 0.026).

Conclusion: In this study the action of lidocaine on the variation of tinnitus intensity was similar to placebo. We believe that the use of manipulated medication may have interfered in the outcome and that the large number of patients with positive response to placebo should be investigated in further studies.

Introduction: The sense of smell plays an essential role in well-being, influencing relationships, the formation of emotional memories, and protection against toxic substances in food and the environment. Post-traumatic olfactory loss is among the leading causes of olfactory alterations, especially in contact sports like Mixed Martial Arts (MMA), which involve frequent physical trauma, particularly to the head. To date, the relationship between olfactory dysfunction and head trauma in fighters remains underexplored.

Objective: To evaluate possible olfactory, gustatory, and cognitive dysfunctions in MMA fighters. Methods: Fourteen MMA fighters and 14 control participants, matched for sex and age, were recruited. The participants underwent tests to evaluate olfaction (Visual Analog Scale (VAS) and the University of Pennsylvania Smell Identification Test (UPSIT), taste (Modified Global Gustatory Test), cognition (Montreal Cognitive Assessment, MoCA) and quality of life (The 36-Item Short Form Health Survey questionnaire, SF-36).

Results: A statistically significant difference was found in olfactory function between the groups (p = 0.021), with fighters having a lower mean score than the control group (fighters: 28.5 ± 4.4 vs. controls: 31.8 ± 2.4). Additionally, MMA fighters showed cognitive decline and impairment in quality of life aspects. No difference was observed in gustatory function between the groups (p = 0.508).

Conclusion: The results indicate that MMA fighters exhibit impairments in olfactory function, as well as in cognition and quality of life. Further studies with larger sample sizes are needed for a more in-depth analysis of the impact of this sport on athletes' lives.

Introduction: Intranasal corticosteroids are widely regarded as the most efficacious remedy for managing moderate to severe allergic rhinitis. However, the Jordanian population's understanding and attitudes toward the safe and proper use of these medications remain ambiguous.

Objective: This study was undertaken to evaluate Jordanian individuals' awareness of intranasal corticosteroids by examining their present perceptions, attitudes, and behaviors regarding these pharmaceuticals.

Methods: We conducted a cross-sectional study within the adult Jordanian demographic using an online survey based on a structured questionnaire.

Results: The study comprised 1509 participants, revealing that 34.2% of the adult Jordanian population suffers from allergic rhinitis, with a prevalence of 39.5% in males and 60.5% in females. Among individuals with allergic rhinitis, 34.1%, 38.4%, 67.1%, and 43.2% hold beliefs regarding the impact of intranasal corticosteroids on blood sugar, blood pressure, pregnancy, and obesity, respectively. Notably, 67.8% of allergic rhinitis patients in our study actively use intranasal corticosteroids, and users demonstrate a significantly higher level of awareness compared with non-users, as we found significantly higher awareness levels among allergic rhinitis patients regarding possible side effects compared with non-allergic rhinitis group (p-value = < .0001, 0.0019, 0.0109, <.0001 and 0.0034) for blood sugar, blood pressure, pregnancy, children less than 5 years and obesity respectively.

Conclusion: The results obtained from this research underscore the critical need for educational initiatives and interventions to enhance understanding and utilization of these medications within Jordan. These efforts can significantly contribute to improved patient outcomes and decreased healthcare expenses.

Introduction: The Eustachian tube is a pressure-equalizing structure, also called the auditory tube, connecting the middle ear to the nasopharynx. Eustachian tube dysfunction is a leading cause of middle-ear infections leading to tympanic-membrane perforation. Therefore, it is necessary to assess the Eustachian tube functioning before determining the management to avoid recurrent middle-ear infections.

Objective: To compare the functional assessment of the Eustachian tube by measuring pressure changes in patients with tympanic-membrane perforation, during the Toynbee test. The effectiveness of wet versus dry swallowing, ease of swallowing, and test-retest reliability for both conditions were examined.

Methods: The study included 52 ears with tympanic-membrane perforations. The Toynbee test involved applying positive pressure to the ear canal while participants performed dry and wet swallowing maneuvers to measure the resulting pressure changes (in daPa). Subjective difficulty ratings were obtained using a 10-point Likert-scale for both swallowing conditions. Additionally, test-retest reliability for each swallowing condition was evaluated in 20 ears.

Results: The pressure changes observed between the open and closed phases during both swallowing conditions differed significantly. Wet swallowing exhibited a larger initial pressure change than dry swallowing ( p  < 0.001). Participants rated wet swallowing as significantly easier in contrast to dry swallowing. Additionally, the test-retest reliability for wet swallowing was good (intraclass correlation coefficient [ICC] = 0.737-0.876), while it was poor for dry swallowing (ICC = 0.282-0.350).

Conclusion: Wet swallowing reliably assesses the Eustachian tube's function in tympanic-membrane perforation cases to aid in informed decision making on the possible method of tympanoplasty.

Introduction: Vitiligo is one of the most common causes of hypopigmentation; it occurs when melanin production is impaired due to the loss of melanocytes, which are present throughout the skin, in the epidermis, and in hair follicles, and are also seen in the mucosa, uvea, and several structures of the inner ear. Scientists have investigated the association between vitiligo and sensorineural hearing loss (SNHL); some believe there is a connection, while others disagree.

Objective: To evaluate the relationship between vitiligo and SNHL.

Methods: The present observational study was conducted from February 2023 to January 2024. A total of 54 patients with clinically diagnosed vitiligo were assessed for hearing impairment. Simultaneously, 50 healthy volunteers were included as a control group, and the data was analyzed to assess any potential association between vitiligo and SNHL.

Results: The mean age of the control group was of 37.5(± 10) years, and that of the patients with vitiligo was of 38.8(± 11) years, and the male-to-female ratio was of 1:1. We observed SNHL in 32 (59.3%) patients with vitiligo, and those with vitiligo vulgaris were the most afflicted. The hearing loss was mild in 2 ears (3.1%), moderate in 24 (37.5%), and severe in 29 (45.3%), with 29 patients belonging to the group with high frequency hearing loss.

Conclusion: Based on the findings; it is imperative that patients with vitiligo undergo routine auditory function assessments to facilitate the early detection of SNHL.

Introduction: Given the widespread use of mobile phones for voice communication, a comprehensive understanding of the objective acoustic alterations in voicemail transmission is lacking, motivating this investigation into voice quality changes.

Objective: This study aims to explore the objective changes in voice recordings caused by mobile phones and voicemail applications during the transmission process, specifically focusing on the alterations to voice quality that occur during this process.

Methods: A volunteer sample of 45 healthy male hospital employees, with an average age of 36.7 ± 7.5 (ranging from 22 to 50), in a tertiary referral center were included in this study. The Multi-Dimensional Voice Program (Kay Elemetrics, Lincoln Park, NJ, USA) was employed to compare a set of nine parameters derived from sustained vowel phonations of /a/, encompassing free-field voice and mobile phone voicemail recordings. Average fundamental frequency (Fo), frequency perturbation parameters [Pitch Period Perturbation Quotient (PPQ), Relative Average Perturbation (RAP)], amplitude perturbation parameters [Shimmer in dB (ShdB), Shimmer Percent (Shim), Amplitude Perturbation Quotient (APQ)], noise parameters [Noise-to-Harmonic Ratio (NHR)] were calculated.

Results: Analysis of the patient data revealed that fundamental frequency (Fo) was resistant to alterations of voice ( p  = 0,313). Frequency perturbation parameters (PPQ, RAP) were impacted ( p  = 0.018, 0.020 respectively), however, amplitude perturbation parameters (ShdB, Shim, APQ) and noise parameter (NHR) were much more affected in voice transmission caused by mobile phones ( p  < 0,001 in all).

Conclusion: The findings of this study indicate that mobile phones induce significant acoustic changes in voicemail transmission. The fundamental frequency remained resistant to alterations in voice.

Introduction: Cholesteatoma remains a serious condition that poses a challenge to otolaryngologists around the world. It is found to be more aggressive in the pediatric group than in adults. If left untreated, the disease can be dangerous due to its ability to expand and destroy bones, leading to complications such as hearing loss, vestibular dysfunction, facial paralysis, and intracranial infections.

Objective: To find out the prevalence of cholesteatoma in the school-aged children of Nepal.

Methods: This is a retrospective study conducted within a span of 10 years from 2014 to 2024 in which all medical records of the school-based ear screening programs were studied. Data including personal details, brief history, and ear and audiometry findings were recorded. All suspected cases of cholesteatoma were reexamined under microscope at our institute, and only those with confirmed diagnosis of chronic otitis media (COM) with cholesteatoma were included in the study.

Results: Out of the total of 143,544 children screened, COM with cholesteatoma was diagnosed in 0.20% (n = 282), and COM in total in 7.56% (n = 10,853). Hearing loss was seen in 273 (96.81%) of the 282 cases, with conductive hearing loss being the most common type of hearing loss.

Conclusion: There is a higher prevalence of cholesteatoma in Nepalese children. Early diagnosis with proper management helps reduce the chances of life-threatening complications. Thus, having regular screening programs in school children will help in reducing morbidity.