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Impact of Drain Placement on Postoperative Complications after Thyroidectomy for Substernal Goiter 放置引流管对胸骨下甲状腺肿甲状腺切除术后并发症的影响
IF 1.1 Q3 Medicine Pub Date : 2024-03-15 DOI: 10.1055/s-0043-1777804
Usama Waqar, A. Hameed, Meher Angez, Sudhesh Kumar, Hajra Arshad, Marium Tariq Siddiqui, Hira Khan, Werdah Viquar, Aiza Abbas, Arsalan Javid, H. Iftikhar, Syed Akbar Abbas, Huma Naz, Sarah Saleem
Introduction Despite the evidence against drain placement after thyroidectomy, there is a lack of consensus on drain use in patients with substernal goiter. Objective To assess the factors that increase the likelihood of drain placement and its impact on postoperative hematoma and other 30-day complications among adult patients undergoing thyroidectomy for substernal goiter. Methods A retrospective cohort study that used data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Adult patients (aged ≥ 18 years) who underwent elective thyroidectomy for substernal goiter from 2016 to 2020 were included. Cases with closed suction neck drains placed upon completion of surgery were included in the drain group, and the remaining cases formed the nondrain group. Results A total of 1,229 patients were included (46.5% with drain placement). The factors that increased the likelihood of drain placement included body mass index (BMI) ≥ 30 kg/m2, score between 3 and 5 on the American Society of Anesthesiologists (ASA) physical status classification, sternal split/transthoracic surgical approach, operative time ≥ 90 minutes, and surgery conducted by otolaryngologists. Patients with clean-contaminated or contaminated wound classifications were less likely to be submitted to drain placement. In addition, drain use had no impact on postoperative hematoma formation but was found to independently increase the risk of prolonged length of hospital stay. Conclusion Thyroidectomy without drain placement might be safe for substernal goiter. However, this decision should be individualized for each patient.Level Of Evidence: 3
引言 尽管有证据表明甲状腺切除术后不应该放置引流管,但对于胸骨下甲状腺肿患者引流管的使用仍缺乏共识。目的 在因胸骨下甲状腺肿而接受甲状腺切除术的成年患者中,评估增加放置引流管可能性的因素及其对术后血肿和其他 30 天并发症的影响。方法 这是一项回顾性队列研究,使用的数据来自美国外科学院国家外科质量改进计划(ACS-NSQIP)。纳入了2016年至2020年期间因胸骨下甲状腺肿大而接受选择性甲状腺切除术的成年患者(年龄≥18岁)。手术完成后放置闭式颈部吸引引流管的病例被纳入引流管组,其余病例被纳入无引流管组。结果 共纳入1229例患者(46.5%的患者放置了引流管)。增加放置引流管可能性的因素包括体重指数(BMI)≥30 kg/m2、美国麻醉医师协会(ASA)身体状况分类评分在3到5分之间、胸骨分割/经胸手术方式、手术时间≥90分钟以及由耳鼻喉科医师进行手术。伤口分类为清洁污染或污染的患者接受引流管置入的可能性较小。此外,引流管的使用对术后血肿的形成没有影响,但会增加住院时间延长的风险。结论 对于胸骨下甲状腺肿,不放置引流管的甲状腺切除术可能是安全的。但这一决定应根据每位患者的具体情况而定:3
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引用次数: 0
Assessment of Peripheral and Central Auditory Processing after Treatment for Idiopathic Sudden Sensorineural Hearing Loss 特发性突发性感音神经性听力损失治疗后的外周和中枢听觉处理评估
IF 1.1 Q3 Medicine Pub Date : 2024-03-15 DOI: 10.1055/s-0043-1776728
Soheila Khakzand, Mohammad Maarefvand, Masoumeh Ruzbahani, A. Tajdini
Introduction When cases of idiopathic sudden sensorineural hearing loss (SSNHL) are treated successfully, most clinicians assume the normality and symmetry of the auditory processing. This assumption is based on the recovery of the detection ability on the part of the patients, but the auditory processing involves much more than detection alone. Since certain studies have suggested a possible involvement of the central auditory system during the acute phase of sudden hearing loss, the present study hypothesized that auditory processing would be asymmetric in people who have experienced sudden hearing loss. Objective To assess the physiologic and electrophysiological conditions of the cochlea and central auditory system, as well as behavioral discrimination, of three primary aspects of sound (intensity, frequency, and time) in subjects with normal ears and ears treated successfully for SSNHL. Methods The study included 19 SSNHL patients whose normal and treated ears were assessed for otoacoustic emissions, speech auditory brainstem response, intensity and pitch discrimination, and temporal resolution in a within-subject design. Results The otoacoustic emissions were poorer in the treated ears compared to the normal ears. Ear- and sex-dependent differences were observed regarding otoacoustic emissions and pitch discrimination. Conclusion The asymmetrical processing observed in the present study was not consistent with the hearing threshold values, which might suggest that the central auditory system would be affected regardless of the status of the peripheral hearing. Further experiments with larger samples, different recovery scenarios after treatment, and other assessments are required.
导言:当特发性突发性感音神经性听力损失(SSNHL)病例得到成功治疗时,大多数临床医生都认为听觉处理过程是正常和对称的。这种假设是基于患者检测能力的恢复,但听觉处理所涉及的远不止检测。由于某些研究表明,在突发性听力损失的急性期,中枢听觉系统可能会受到影响,因此本研究假设突发性听力损失患者的听觉处理过程将是不对称的。目的 评估正常耳朵和成功治疗过 SSNHL 的耳朵的耳蜗和中枢听觉系统的生理和电生理状况,以及对声音的三个主要方面(强度、频率和时间)的行为分辨能力。方法 该研究纳入了 19 名 SSNHL 患者,采用受试者内设计对他们的正常耳朵和接受过治疗的耳朵进行了声发射、言语听觉脑干反应、强度和音高分辨力以及时间分辨率评估。结果 与正常耳相比,治疗耳的耳声发射较差。在耳声发射和音调辨别方面,观察到了与耳和性别有关的差异。结论 本研究中观察到的非对称处理与听力阈值不一致,这可能表明无论外周听力状况如何,中枢听觉系统都会受到影响。还需要对更大的样本、治疗后不同的恢复情况和其他评估进行进一步的实验。
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引用次数: 0
The Effects of Nasal Septal Deviation on Anterior Skull Base Parameters 鼻中隔偏曲对前颅底参数的影响
IF 1.1 Q3 Medicine Pub Date : 2024-03-11 DOI: 10.1055/s-0043-1773760
Şeyda Akbal Çufalı, Mehmet Ali Çetin, N. Kum, S. E. Karakurt
Introduction Functional endoscopic sinus surgery and endoscopic skull base surgery are frequently performed surgeries today. Nasal septal deviation is a common finding and can affect the surgical area. Therefore, it is important to examine the effect of this deviation on other anatomical structures. Objectıve The aim of the present study was to determine whether there is a relationship between the degree of nasal septal deviation and anterior skull base structures using computed tomography (CT). Methods A total of 312 patients (aged 18 to 65 years old) whose paranasal sinus CT images were available were included in the study. Measurements were obtained on images retrieved from Picture Archiving and Communication System (PACS) and Horos image archive systems in the bone window in the coronal and axial plane. Results The mean age of 312 patients was 33.00 years old (standard deviation [SD] 11.22 years). The presence of septal deviation was not associated with changes in olfactory fossa (OF) depths, Keros degrees, and the angle between the lateral lamella and the cribriform lamella. However, OF depths and Keros degrees on the deviated side of the septum were found to change at a significant level (p < 0.05). No significant association was observed between the degree of septal deviation and cribriform lamella-lateral lamella angle. Conclusion The study showed significantly increased OF depth and Keros degree on the deviated side of the nasal septum. Performing CT scans before endoscopic sinus surgery and endoscopic skull base surgery is important to increase the chances of a successful surgical outcome and to reduce complications.
引言 功能性内窥镜鼻窦手术和内窥镜颅底手术是当今经常进行的手术。鼻中隔偏曲是一种常见现象,会影响手术区域。因此,研究鼻中隔偏曲对其他解剖结构的影响非常重要。目的 本研究旨在通过计算机断层扫描(CT)确定鼻中隔偏曲程度与前颅底结构之间是否存在关系。方法 本研究共纳入了 312 名有鼻旁窦 CT 图像的患者(18 至 65 岁)。对从图像存档和通信系统(PACS)和 Horos 图像存档系统中获取的骨窗图像进行冠状面和轴向测量。结果 312 名患者的平均年龄为 33.00 岁(标准差 [SD] 11.22 岁)。鼻中隔偏曲的存在与嗅窝(OF)深度、Keros度以及外侧薄片与楔形薄片之间角度的变化无关。然而,研究发现鼻中隔偏曲侧的嗅窝深度和 Keros 度的变化具有显著性(p < 0.05)。鼻中隔偏曲程度与楔形薄片-外侧薄片角度之间未发现明显关联。结论 研究显示,鼻中隔偏曲侧的 OF 深度和 Keros 度明显增加。在内窥镜鼻窦手术和内窥镜颅底手术前进行 CT 扫描对于提高手术成功率和减少并发症非常重要。
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引用次数: 0
Active Bone Conduction Implant and Adhesive Bone Conduction Device: A Comparison of Audiological Performance and Subjective Satisfaction 有源骨传导植入体和粘附性骨传导装置:听力学性能和主观满意度比较
IF 1.1 Q3 Medicine Pub Date : 2024-03-11 DOI: 10.1055/s-0043-1777416
M. F. Di Gregorio, Carolina Der, Sofía Bravo-Torres, M. Zernotti
Introduction Atresia of the external auditory canal affects 1 in every 10 thousand to 20 thousand live births, with a much higher prevalence in Latin America, at 5 to 21 out of every 10 thousand newborns. The treatment involves esthetic and functional aspects. Regarding the functional treatment, there are surgical and nonsurgical alternatives like spectacle frames and rigid and softband systems. Active transcutaneous bone conduction implants (BCIs) achieve good sound transmission and directly stimulate the bone. Objective To assess the audiological performance and subjective satisfaction of children implanted with an active transcutaneous BCI for more than one year and to compare the outcomes with a nonsurgical adhesive bone conduction device (aBCD) in the same users. Methods The present is a prospective, multicentric study. The audiological performance was evaluated at 1, 6, and 12 months postactivation, and after a 1-month trial with the nonsurgical device. Results Ten patients completed all tests. The 4-frequency pure-tone average (4PTA) in the unaided condition was of 65 dB HL, which improved significantly to 20 dB HL after using the BCI for 12 months. The speech recognition in quiet in the unaided condition was of 33% on average, which improved significantly, to 99% with the BCI, and to 91% with the aBCD. Conclusion The aBCD demonstrated sufficient hearing improvement and subjective satisfaction; thus, it is a good solution for hearing rehabilitation if surgery is not desired or not possible. If surgery is an option, the BCI is the superior device in terms of hearing outcomes, particularly background noise and subjective satisfaction.
导言:每 1 万至 2 万名活产婴儿中就有 1 名患有外耳道闭锁,拉丁美洲的发病率更高,每 1 万名新生儿中就有 5 至 21 名患有这种疾病。治疗涉及美学和功能两个方面。在功能治疗方面,有手术和非手术疗法,如眼镜框、硬带和软带系统。有源经皮骨传导植入体(BCIs)可实现良好的声音传输并直接刺激骨骼。目的 评估植入有源经皮骨传导植入体一年以上的儿童的听力表现和主观满意度,并将其结果与相同用户的非手术粘合骨传导装置(aBCD)进行比较。方法 这是一项前瞻性多中心研究。在激活后 1 个月、6 个月和 12 个月,以及使用非手术设备试用 1 个月后,对听力表现进行评估。结果 10 名患者完成了所有测试。无助听状态下的四频纯音平均值(4PTA)为 65 dB HL,在使用 BCI 12 个月后明显降低至 20 dB HL。在无辅助状态下,安静时的语音识别率平均为 33%,使用 BCI 后,语音识别率显著提高到 99%,使用 aBCD 后,语音识别率提高到 91%。结论 aBCD 能够充分改善听力并提高主观满意度;因此,在不希望或不可能进行手术的情况下,它是听力康复的良好解决方案。如果可以选择手术,从听力效果(尤其是背景噪声)和主观满意度来看,BCI 是更优越的设备。
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引用次数: 0
Cephalometric Evaluation in Patients with Obstructive Sleep Apnea undergoing Lateral Pharyngoplasty. 对接受侧咽喉成形术的阻塞性睡眠呼吸暂停患者进行头颅测量评估。
IF 1.1 Q3 Medicine Pub Date : 2024-03-06 eCollection Date: 2024-04-01 DOI: 10.1055/s-0043-1776718
Stephanie Regiane Prata Ferreira Zanco, Bruno Bernardo Duarte, Aurélio Rochael Almeida, José Alexandre Mendonça

Introduction  Lateral pharyngoplasty (LP) has shown promising results. Craniofacial deformity reduces the pharyngeal space, contributing to the etiopathogenesis. The analysis of craniofacial features can be performed using cephalometry. Objective  To verify if craniofacial deformity is associated with worse polysomnographic data in patients with obstructive sleep apnea (OSA), and to verify if the preoperative cephalometric parameters can interfere with the surgical success of the LP. Methods  The study included 21 patients with OSA aged between 18 and 65 years who underwent LP in a university hospital from 2015 to 2019. Polysomnography was performed postoperatively, after a minimum period of 6 months from the surgical procedure. In addition, a cephalometric evaluation was performed to assess craniofacial deformity, and to correlate it with the polysomnographic results. Results  The mean and median of all polysomnographic respiratory parameters improved postoperatively, especially the apnea-hypopnea index (AHI), which went from 40.15 to 16.60 events per hour ( p  = 0.001). Of the 21 patients, 15 showed improvements in the AHI postoperatively. As for the cephalometric evaluations, we found that the longer the distance between the hyoid bone and the mandibular plane, the greater the patient's preoperative AHI ( p  = 0.011). When assessing whether cephalometric changes related to craniofacial deformities influence the surgical outcome of LP, no correlation was found for any cephalometric measurement. Conclusion  The longer the distance between the hyoid bone and the mandibular plane, the greater the preoperative AHI, and LP was an effective OSA treatment. Cephalometric variables are not able to modify or determine the success of LP in apneic patients in the population assessed.

导言:侧咽成形术(LP)已经取得了良好的效果。颅面畸形缩小了咽部空间,是导致咽喉炎的病因之一。头颅测量法可对颅面特征进行分析。目的 验证颅面畸形是否与阻塞性睡眠呼吸暂停(OSA)患者较差的多导睡眠图数据有关,并验证术前头颅测量参数是否会干扰 LP 手术的成功。方法 该研究纳入了 21 名 OSA 患者,他们的年龄在 18 岁至 65 岁之间,于 2015 年至 2019 年期间在一家大学医院接受了 LP 手术。术后至少 6 个月后进行多导睡眠图检查。此外,还进行了头颅测量评估,以评估颅面畸形,并将其与多导睡眠图结果相关联。结果 所有多导睡眠图呼吸参数的平均值和中位数在术后均有所改善,尤其是呼吸暂停-低通气指数(AHI),从每小时 40.15 次下降到 16.60 次(P = 0.001)。在 21 名患者中,有 15 名患者的 AHI 在术后有所改善。在头颅测量评估方面,我们发现舌骨与下颌骨平面之间的距离越长,患者术前的 AHI 就越大(p = 0.011)。在评估与颅面畸形相关的头测量变化是否会影响 LP 的手术效果时,没有发现任何头测量值与之相关。结论 舌骨与下颌骨平面之间的距离越长,术前 AHI 越大,LP 是一种有效的 OSA 治疗方法。在所评估的人群中,头颅测量变量无法改变或决定对呼吸暂停患者进行 LP 治疗的成功与否。
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引用次数: 0
Endoscopic Evaluation after Conventional Adenoid Curettage. 传统腺样体切除术后的内窥镜评估
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-02-16 eCollection Date: 2024-07-01 DOI: 10.1055/s-0044-1779434
Ahmed Abdelfattah Bayomy Nofal, Mohamed Abdelmohsen Alnemr, Ahmed Hassan Sweed, Alsayed Abdulmageed

Introduction  Adenoidectomy is one of the most common procedures performed by otolaryngologists. Traditional adenoid curettage is performed blindly, which can result in inadequate removal of the adenoid and injury to the surrounding structures. Objective  To perform transnasal endoscopic examinations to assess the nasopharynx after conventional curettage adenoidectomy. Methods  The present prospective study included 100 children with a mean age of 4.2 ± 3.07 years. It is composed of two steps: conventional curettage adenoidectomy by a resident trainee; and endoscopic evaluation of the nasopharynx through a 0° telescope to assess adenoidal remnants, injury to the surgical field or adjacent structures, and bleeding points. Results  Adenoid remnants were observed in 42% of the cases after conventional adenoid curettage in multiple locations, such as the roof of the nasopharynx over the choana (24%), the tubal tonsil (12%), the posterior pharyngeal wall (4%), and the posterior end of the nasal septum (2%). Injury to the surgical field and adjacent structures was observed in 46% of the cases (posterior pharyngeal wall: 23%; lateral pharyngeal wall: 11%; Passavant ridge: 10%; and the Eustachian tube orifice: 2%). Endoscopic bleeding was observed in 29% of the cases; 13% of the cases were from adenoid remnants, 10%, from the mucosa, and 6%, from the pharyngeal muscles. Bleeding was mild in 19% of the cases, moderate in 9%, and severe in 1%. Conclusion  Endoscopic evaluation of the nasopharynx following conventional adenoid curettage provides important data regarding adenoid remnants, injury to the surgical field or nearby structures, and bleeding points, which aids in the provision of optimal care and in the achievement of a better outcome.

导言:腺样体切除术是耳鼻喉科医生最常见的手术之一。传统的腺样体刮除术是盲目进行的,可能导致腺样体切除不充分和周围结构损伤。目的 通过经鼻内窥镜检查评估传统腺样体刮除术后的鼻咽部情况。方法 本前瞻性研究包括 100 名儿童,平均年龄为 4.2 ± 3.07 岁。研究包括两个步骤:由一名住院受训者进行常规刮治腺样体切除术;通过0°望远镜对鼻咽部进行内窥镜评估,以评估腺样体残留、手术区域或邻近结构的损伤以及出血点。结果 42% 的病例在常规腺样体刮除术后多个部位观察到腺样体残留,如鼻咽顶部咽喉部(24%)、输卵管扁桃体(12%)、咽后壁(4%)和鼻中隔后端(2%)。46%的病例观察到手术区域和邻近结构受到损伤(咽后壁:23%;咽侧壁:11%; Passavant脊:5%):咽后壁:23%;咽侧壁:11%;咽嵴:10%;咽鼓管口:2%):2%).29%的病例观察到内镜下出血,其中13%来自腺样体残留物,10%来自粘膜,6%来自咽部肌肉。19%的病例为轻度出血,9%为中度出血,1%为严重出血。结论 传统腺样体刮除术后的鼻咽部内窥镜评估提供了有关腺样体残留、手术区域或附近结构损伤以及出血点的重要数据,有助于提供最佳护理和取得更好的疗效。
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引用次数: 0
Rate and Causes of Unplanned Hospital Returns within 60 Days following Head and Neck Surgery. 头颈部手术后 60 天内计划外退院的比例和原因。
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-02-16 eCollection Date: 2024-07-01 DOI: 10.1055/s-0044-1779433
Mazin Merdad, Abdulsalam Alqutub, Ahmed Mogharbel, Abdullah Farid, Abdullah Bayazed, Abdulaziz Alghamdi, Yazeed Albogami, Rayan Alshehri, Majed N Alnefaie, Hanin A Alamoudi

Introduction  Unplanned hospital returns are frequent and may be preventable. Objective  To comprehend the reasons for unplanned hospital readmission and return to the Outpatient Department (OPD) and Emergency Department (ED) within 60 days after discharge following head and neck surgery (HNS) at a tertiary care center in Saudi Arabia. Methods  In the present retrospective study, the medical records of all patients who underwent HNS for benign and malignant conditions between January 2015 and June 2022 were reviewed in terms of demographic data, comorbidities, and reasons for hospital return. Results  Out of 1,030 cases, 119 (11.55%) returned to the hospital within 60 days after discharge, 19 of which (1.84%) were readmitted. In total, 90 (8.74%) patients returned to the OPD, and 29 (2.82%), to the ED. The common reasons for readmission included infections (26.32%) and neurological symptoms (21.05%). For OPD visits, the common causes were hematoma (20%) and neurological symptoms (14.44%). For ED returns, the frequent causes were neurological symptoms (20.69%) and equipment issues (17.24%). Compared with nonreadmitted patients, readmitted patients had a higher preoperative baseline health burden when examined using the American Society of Anesthesiologists (ASA) score ( p  = 0.004) and the Cumulative Illness Rating Scale (CIRS; p  = 0.002). Conclusion  The 60-day rates of unplanned hospital return to the OPD and ED were of 8.74% and 2.82% respectively, and 1.84% of the patients were readmitted. Hematoma, infections, and neurological symptoms were common causes. Addressing the common reasons may be beneficial to decrease postoperative hospital visits.

导言:非计划再次入院的情况经常发生,而且可能是可以预防的。目的 了解沙特阿拉伯一家三级医疗中心头颈部手术(HNS)出院后 60 天内非计划再入院以及重返门诊部(OPD)和急诊部(ED)的原因。方法 在本回顾性研究中,研究人员查阅了 2015 年 1 月至 2022 年 6 月期间所有因良性和恶性疾病接受头颈外科手术的患者的病历,包括人口统计学数据、合并症和复诊原因。结果 在 1030 个病例中,119 例(11.55%)在出院后 60 天内返回医院,其中 19 例(1.84%)再次入院。共有 90 名(8.74%)患者返回手术室,29 名(2.82%)返回急诊室。再次入院的常见原因包括感染(26.32%)和神经症状(21.05%)。在手术室就诊的患者中,常见原因是血肿(20%)和神经症状(14.44%)。就急诊室复诊而言,常见原因是神经系统症状(20.69%)和设备问题(17.24%)。与未入院患者相比,使用美国麻醉医师协会(ASA)评分(P = 0.004)和累积疾病评分量表(CIRS;P = 0.002)检查再入院患者的术前基线健康负担较高。结论 60 天内手术室和急诊室非计划返院率分别为 8.74% 和 2.82%,1.84% 的患者再次入院。血肿、感染和神经症状是常见原因。解决这些常见原因可能有利于减少术后住院次数。
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引用次数: 0
Olfaction and Quality of Life in Patients with Eosinophilic CRS Undergoing Endoscopic Sinus Surgery. 接受内窥镜鼻窦手术的嗜酸性粒细胞 CRS 患者的嗅觉和生活质量
IF 1.1 Q3 Medicine Pub Date : 2024-02-16 eCollection Date: 2024-04-01 DOI: 10.1055/s-0043-1772494
Miguel Soares Tepedino, Richard Louis Voegels, Rogério Pezato, Andrew Thamboo, Eduardo Macoto Kosug, Ana Clara Miotello Ferrão, Raíssa de Figueiredo Neves, Valéria Maria Barcia Castilla, Luis Carlos Gregório

Introduction  Chronic rhinosinusitis (CRS) is a common inflammatory disease. This high prevalence leads to high direct and indirect public health costs, which include medical visits, laboratory tests and imaging, pharmacotherapy, hospitalizations, and surgical treatment. Furthermore, CRS has a substantial impact on patient quality of life, affecting productivity and being a common cause of absence from work CRS-associated olfactory dysfunction is highly prevalent, the actual effectiveness of surgical intervention remains inconsistent. Although there are studies evaluating the postoperative course of patients with eosinophilic Chronic rhinosinusitis (eCRS) treated with high-volume budesonide irrigation, there is little objective information regarding the impact of this intervention on olfactory status and quality of life. Objective  To conduct a pre- and postoperative analysis of olfaction and quality of life in patients with eCRS treated with surgical intervention followed by high-volume budesonide nasal irrigation. Methods  Prospective, descriptive, uncontrolled study of patients with eCRS. All patients underwent pre- and postoperative nasal endoscopy, SNOT-22 questionnaire, and the University of Pennsylvania Smell Identification Text (UPSIT), always by the same previously trained examiner. The SNOT-22 questionnaire and the UPSIT were readministered to all patients at 3 months, 6 months, and 1 year postoperatively, and scores compared with those obtained preoperatively. Results  Twenty patients were included in the study, 13 males and 7 females, between the ages of 23 and 65; 8 patients had comorbid asthma. Quantitative evaluation using the UPSIT test showed a significant improvement in olfaction 3 months after surgery, which remained 6 months and 1 year after surgery (p = 0.0063). There was no significant association between eosinophil concentrations in polypoid tissue and postoperative SNOT-22 and UPSIT results. Patients with tissue eosinophils >50 had a lower preoperative UPSIT score. As early as 3 months postoperatively, a significant improvement in quality of life was already noticeable, as represented by a decrease in SNOT-22 values, which persisted through the 1-year postoperative follow-up evaluation (p = 0.0005). Quantitative evaluation using the UPSIT test showed a significant improvement in olfaction 3 months after surgery, which remained 6 months and 1 year after surgery (p = 0.0063). Conclusion  Surgery effectively controlled eCRS in patients who adhered to high-volume budesonide nasal irrigation postoperatively. There were significant improvements in quality of life and olfaction, which persisted at least up to one year postoperatively.

导言:慢性鼻炎(CRS)是一种常见的炎症性疾病。这种高发病率导致了高昂的直接和间接公共卫生成本,其中包括就诊、实验室检查和影像学检查、药物治疗、住院治疗和手术治疗。此外,CRS 还严重影响患者的生活质量,影响工作效率,是缺勤的常见原因之一。CRS 相关的嗅觉功能障碍非常普遍,但手术干预的实际效果仍不一致。虽然有研究评估了嗜酸性粒细胞慢性鼻炎(eCRS)患者接受大量布地奈德冲洗治疗的术后疗程,但关于这种干预措施对嗅觉状态和生活质量的影响的客观信息却很少。目的 对接受手术治疗后进行大容量布地奈德鼻腔冲洗的 eCRS 患者的嗅觉和生活质量进行术前和术后分析。方法 对 eCRS 患者进行前瞻性、描述性、非对照研究。所有患者均接受了术前和术后鼻内窥镜检查、SNOT-22 问卷调查和宾夕法尼亚大学气味识别文本(UPSIT)测试,所有测试均由之前接受过培训的同一检查人员进行。所有患者在术后 3 个月、6 个月和 1 年时重新接受 SNOT-22 问卷和 UPSIT 测试,并将得分与术前进行比较。结果 研究共纳入 20 名患者,其中男性 13 名,女性 7 名,年龄在 23 岁至 65 岁之间;8 名患者合并有哮喘。使用 UPSIT 测试进行的定量评估显示,术后 3 个月嗅觉有明显改善,术后 6 个月和 1 年仍有改善(p = 0.0063)。息肉组织中的嗜酸性粒细胞浓度与术后 SNOT-22 和 UPSIT 结果之间没有明显关联。组织中嗜酸性粒细胞大于 50 的患者术前 UPSIT 评分较低。早在术后 3 个月,患者的生活质量就有了明显改善,这体现在 SNOT-22 值的降低上,这种改善一直持续到术后 1 年的随访评估(p = 0.0005)。使用 UPSIT 测试进行的定量评估显示,术后 3 个月嗅觉明显改善,术后 6 个月和术后 1 年仍然如此(p = 0.0063)。结论 对于术后坚持使用大量布地奈德鼻腔冲洗的患者,手术能有效控制 eCRS。患者的生活质量和嗅觉得到了明显改善,这种改善至少持续到术后一年。
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引用次数: 0
Study of Speech Recognition in Noise and Working Memory in Adults and Elderly with Normal Hearing. 研究听力正常的成年人和老年人在噪音中的语音识别能力和工作记忆能力。
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-02-16 eCollection Date: 2024-07-01 DOI: 10.1055/s-0044-1779432
Daniela Aiko Akashi, Maria Cecília Martinelli

Introduction  In clinical practice, patients with the same degree and configuration of hearing loss, or even with normal audiometric thresholds, present substantially different performances in terms of speech perception. This probably happens because other factors, in addition to auditory sensitivity, interfere with speech perception. Thus, studies are needed to investigate the performance of listeners in unfavorable listening conditions to identify the processes that interfere in the speech perception of these subjects. Objective  To verify the influence of age, temporal processing, and working memory on speech recognition in noise. Methods  Thirty-eight adult and elderly individuals with normal hearing thresholds participated in the study. Participants were divided into two groups: The adult group (G1), composed of 10 individuals aged 21 to 33 years, and the elderly group (G2), with 28 participants aged 60 to 81 years. They underwent audiological assessment with the Portuguese Sentence List Test, Gaps-in-Noise test, Digit Span Memory test, Running Span Task, Corsi Block-Tapping test, and Visual Pattern test. Results  The Running Span Task score proved to be a statistically significant predictor of the listening-in-noise variable. This result showed that the difference in performance between groups G1 and G2 in relation to listening in noise is due not only to aging, but also to changes in working memory. Conclusion  The study showed that working memory is a predictor of listening performance in noise in individuals with normal hearing, and that this task can provide important information for investigation in individuals who have difficulty hearing in unfavorable environments.

引言 在临床实践中,听力损失程度和结构相同的患者,甚至听阈正常的患者,在言语感知方面的表现却大相径庭。出现这种情况的原因可能是,除了听觉灵敏度之外,还有其他因素干扰了言语感知。因此,需要对听者在不利听力条件下的表现进行研究,以确定干扰这些受试者言语感知的过程。目的 验证年龄、时间处理和工作记忆对噪声中语音识别的影响。方法 38 名听阈正常的成年人和老年人参加了研究。参与者分为两组:成人组(G1)10 人,年龄在 21 至 33 岁之间;老年人组(G2)28 人,年龄在 60 至 81 岁之间。他们接受了听力评估,包括葡萄牙语句子列表测试、噪音间隙测试、数字跨度记忆测试、奔跑跨度任务、Corsi 方块敲击测试和视觉模式测试。结果 跑步跨度任务得分被证明对噪声中听力变量有显著的统计学预测作用。这一结果表明,G1 组和 G2 组在噪声中听力方面的表现差异不仅是由于老化,还与工作记忆的变化有关。结论 该研究表明,工作记忆可以预测听力正常的人在噪声中的听力表现,这项任务可以为调查在不利环境中听力有困难的人提供重要信息。
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引用次数: 0
The Effect of Simultaneous Contralateral White Noise Masking on Cortical Auditory Evoked Potentials Elicited by Speech Stimuli. 同时对侧白噪声掩蔽对言语刺激引起的皮层听觉诱发电位的影响
IF 1.1 Q3 Medicine Pub Date : 2024-02-05 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1767675
Luiza Dandara de Araújo Felix, Pedro Lemos Menezes, Lisiane Vital de Oliveira, Carlos Henrique Alves Batista, Aline Tenório Lins Carnaúba, Kelly Cristina Lira de Andrade

Introduction  Noise obscures speech signal, causing auditory masking. The effects of this masking can be observed through the cortical auditory evoked potentials (CAEPs). White noise, in turn, has an effect on the auditory cortex, interfering, for example, with lexical decision making. Objective  To analyze the effect of simultaneous masking by contralateral white noise on CAEPs elicited by speech stimuli. Methods  Cross-sectional observational analytical study carried out with 15 participants of both sexes, who were submitted to CAEPs in two conditions: 1) without noise; 2) with white noise at 100 dBSPL intensity, contralaterally and simultaneously. To compare these conditions, the Student t test or the Wilcoxon test were used, depending on the sample normality. Differences with p values < 0.05 were considered significant. Results : When white noise was presented contralaterally and simultaneously to the CAEPs with speech stimulus, an increase in P1, N1 and P2 wave latencies was observed. P1 and P2 amplitudes and N1-P2 peak to peak amplitude also increased, unlike N1 amplitude, which decreased. The differences were significant for P1 and P2 wave latencies and for P2 wave amplitude. Conclusion  The simultaneous masking effect was observed from the morphological alterations of the CAEPs with speech stimulus when white noise was presented in the contralateral ear. There was a significant increase in P1 and P2 wave latencies, as well as in P2 wave amplitude.

引言 噪声会掩盖语音信号,造成听觉掩蔽。这种掩蔽的影响可以通过皮层听觉诱发电位(CAEPs)观察到。反过来,白噪声也会对听觉皮层产生影响,例如干扰词汇决策。目的 分析对侧白噪声同时掩蔽对言语刺激引起的 CAEPs 的影响。方法 对 15 名男女参与者进行横断面观察分析研究,他们在两种条件下接受 CAEPs:1) 无噪声;2) 100 dBSPL 强度的白噪声,对侧同时进行。根据样本的正态性,采用学生 t 检验或 Wilcoxon 检验对这两种情况进行比较。P 值小于 0.05 的差异被视为显著差异。结果:当白噪声与语音刺激同时出现在 CAEPs 的对侧时,观察到 P1、N1 和 P2 波潜伏期增加。P1 和 P2 波幅以及 N1-P2 波峰至峰值波幅也有所增加,而 N1 波幅则有所减少。P1 和 P2 波潜伏期和 P2 波振幅的差异显著。结论 当白噪声在对侧耳中出现时,从 CAEPs 的形态学变化中可以观察到语音刺激的同步掩蔽效应。P1 波和 P2 波潜伏期以及 P2 波振幅明显增加。
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引用次数: 0
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International Archives of Otorhinolaryngology
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