International Archives of Otorhinolaryngology最新文献

Introduction: Allergic rhinitis is a disease that negatively affects social and work life and sometimes does not respond to many treatments. Therefore, new treatments are needed. For the prevention and treatment of allergies, oleuropein has been emphasized, and positive results have been shown in the literature.

Objective: To investigate the effects of general and topical oleuropein during the allergic rhinitis period and the histopathological changes in the nasal mucosa compared with steroid nasal sprays and control group in rats.

Methods: We developed an experimental animal model with 44 rats divided into 6 groups. Except for the control group, the allergic rhinitis in the other five groups was created with ovalbumin. As treatment, saline was administered to group 3, steroids, to group 4, oleuropein, to group 5, and steroids and oleuropein were administered to group 6. The effects of the drugs were examined histopathologically and the levels of immunoglobulin E (IgE) in the blood were compared.

Results: Considering the symptomatic findings in rats, we could observe that allergic rhinitis occurred. Based on the IgE levels and histopathological findings, we have statistically shown that oleuropein may be effective in treatment of allergy rhinitis.

Conclusion: Oleuropein has been shown to be useful in the treatment of allergic rhinitis in an animal model, but further studies are needed before it is introduced into the medical practice.

Introduction  Mucormycosis, a fungal infection with severe consequences, gained prominence during the coronavirus disease 2019 (COVID-19) pandemic. While significant efforts were made to understand the systemic implications of mucormycosis, its effect on the auditory system remains unexplored. Objective  This study aimed to investigate the auditory implications of mucormycosis through a comprehensive case-control study focusing on hearing loss and middle ear dysfunction. Methods  A total of 30 mucormycosis patients without prior auditory issues, and 30 age and gender-matched controls, underwent comprehensive hearing assessment, including pure-tone and immittance audiometry. Statistical analyses, including descriptive statistics, Mann-Whitney U test, Pearson chi-square test, and multiple logistic regression were performed to analyze the data. Result  Mucormycosis patients exhibited significantly higher auditory thresholds across all frequencies compared to controls ( p  < 0.05). Approximately half of these patients experienced some degree of hearing loss, predominantly mild. Immittance measurement showed a higher prevalence of abnormal tympanograms in mucormycosis patients, indicating middle ear dysfunction. Acoustic reflex was absent in half of the mucormycosis patients suggesting impaired auditory function. Conclusion  The present study revealed significant auditory health impacts of mucormycosis, finding a notable prevalence of hearing loss and middle ear dysfunction, which emphasizes the need for routine audiological evaluations and increased awareness of mucormycosis-related auditory issues. Despite the study's limitations, we identified potential risk factors for hearing impairment, suggesting a need for further large-scale studies to confirm these findings and understand the mechanisms. These insights aim to improve diagnosis, treatment, and prevention strategies for better clinical outcomes.

Introduction  Obstructive sleep apnea (OSA) is a prevalent condition often managed with continuous positive airway pressure (CPAP) treatment. There is an ongoing debate about the link between OSA and cardiovascular disease (CVD), but the existing evidence points toward an association. Objective  The present study aims to investigate whether CPAP is an effective strategy to reduce the risk of developing CVD risk among OSA patients. Methods  The literature search was conducted in collaboration with Weill Cornell Medical College librarians, and we identified the five most recent papers highlighting the correlation between CPAP treatment for OSA and CVD risk reduction. Results  Recent studies highlight the link between OSA and CVD, emphasizing the potential of the CPAP therapy to reduce the risks of developing CVD and the mortality associated with the condition. The analyses by Guo et al., Peker et al., Khan et al., and Wickwire et al., collectively involving thousands of patients across various study designs, including randomized clinical trials and retrospective cohort studies, consistently demonstrate that the CPAP treatment improves cardiovascular outcomes by lowering blood pressure, reducing sleepiness scores, and significantly decreasing the risk of serious CVD events, especially with consistent adherence to therapy. Conclusion  Although further studies are needed to confirm these findings among patients with consistent high compliance to the CPAP treatment, it remains reasonable to continue to prescribe CPAP as the first-line therapy for OSA due to its potential cardiovascular benefits and low associated risks.

Introduction: Nasal irrigation is a standard therapeutic option to clean the upper airways to remove abundant secretions and harmful substances. The Nasal Wash (SIIT, Milan, Italy) sinus irrigation system contains saline, bicarbonates, and polyethylene glycol.

Objective: The present randomized controlled trial evaluated and compared the Nasal Wash hypertonic solution (NW-HS) with physiological saline (PS) in patients with nasal symptoms common to different upper airway diseases (infectious rhinitis, allergic rhinitis, and acute and chronic rhinosinusitis).

Methods: The symptomatic patients were divided into two groups: those receiving NW-HS 1 to 2 times a day for 7 days and those receiving PS 1 to 2 times a day for 7 days. The primary efficacy measures included total nasal symptom score (TNSS) and the score on the verbal numeric rating scale (VNRS), assessed at baseline and during the treatment period.

Results: In total, 70 patients participated in the trial: 35 were allocated to the NW-HS group and 35 to the PS group. In the NW-HS group, we observed a significant reduction in the TNSS over time, at rates higher than those of the PS group ( p  < 0.001), as well as a significant reduction in the VNRS score at all observation times, and also at rates higher than those of the PS group ( p  < 0.001). The safety was good for all patients.

Conclusion: The present trial documented the efficacy and safety of NW-HS in the treatment of nasal symptoms common to upper respiratory tract disorders. Most of the beneficial effects appeared as early as three days after the beginning of the treatment. In addition, compared to PS, NW-HS showed impressive results; thus, it may represent a safe and valuable option in the non-pharmacological therapy for rhinitis.

Introduction: Newborn hearing screenings must be completed within 48 hours of birth.

Objective: To determine the optimal timing for the first transient evoked otoacoustic emissions (TEOAEs) test by comparing the referral rates of infants tested between different time intervals.

Methods: The present study was a retrospective cohort analysis of 2,713 newborns who underwent TEOAE tests between February 2021 and June 2022. The infants were categorized into groups according to the age at which they were tested: 12 to 24 hours, 25 to 36 hours, 37 to 48 hours, and > 48 hours. We compared referral rates across these groups.

Results: The overall referral rate for infants tested within 48 hours from birth was 53%, significantly higher than the rate for those tested after 48 hours (46%, p  = 0.001). Notably, the highest referral rates were observed in neonates aged 25 to 36 hours. However, no significant difference in referral rates was found for high-risk infants tested either before or after 48 hours.

Conclusion: Transient evoked otoacoustic emissions can be used to screen newborns' hearing within 48 hours, but the high referral rate suggests that Thailand should add automated auditory brainstem response (AABR) to its guidelines for hearing evaluation if newborns leave the hospital before 48 hours.

Introduction: Complaints of smell and taste disorders are present in people with coronavirus disease 2019 (COVID-19), and they particularly impact older adults in their daily activities and quality of life. Understanding these disorders in this specific population is crucial due to the heightened susceptibility to decreased general health.

Objective: To assess the prevalence and the factors associated with self-reported smell and taste disorders in older adults hospitalized with COVID-19.

Methods: The present documentary and retrospective study used a dataset from the Paraíba State Department of Health based on individual record sheets of hospitalized people with severe acute respiratory syndrome (SARS), collected through a national form routinely applied in Brazilian hospitals. The complaints of smell and taste disorders were the dependent variables. The independent variables included the clinical outcomes and comorbidities. Data analysis involved descriptive statistics, the Fisher's exact test, and binary logistic regression. The confidence interval was 95%.

Results: The sample comprised 5,014 older adults with a mean age of 74.50 ± 9.35 years, of both biological sexes, and most of them were admitted to the Intensive Care Unit (ICU), required non-invasive respiratory support, and experienced death. The prevalence of self-reported smell and taste disorders was 7.8% (95%CI = 7.2-8.8%) and 6.4% (95%CI = 5.6-7.1%) respectively. Smell disorders were less frequent among subjects admitted to the ICU and those who died, while taste disorders correlated with clinical outcomes such as fever, cough, sore throat, diarrhea, and comorbidities such as chronic neurological disease.

Conclusion: Self-reported smell and taste disorders are present in almost 10% of older adults hospitalized with COVID-19, and they are associated with clinical outcomes and commorbities.

Introduction: Dysphagia affects a significant number of patients with Alzheimer's dementia. Neuromuscular electrical stimulation may be a promising resource for dysphagia rehabilitation in this population.

Objective: To investigate the immediate effects of neuromuscular electrical stimulation on hyoid bone displacement, pharyngeal transit time, and swallowing safety in elderly people with Alzheimer's dementia.

Methods: We evaluated 30 elderly individuals with an average age of 82.79 years, regardless of the stage of dementia and with reduced hyolaryngeal elevation, using the Northwestern Dysphagia Patient Check Sheet. Neuromuscular electrical stimulation was performed at the sensory and motor levels in the submental region during videofluoroscopy, with food being offered in solid, pudding, and liquid consistencies, and in portions of 5 mL and 10 mL. We applied Analysis of variance and the Friedman test, adopting a significance level of < 5%.

Results: The comparison between the sensory and motor levels of stimulation showed that there was a significant difference in hyoid bone displacement for the mushy consistency, with neuromuscular stimulation at the motor level. There was no difference in the application of stimuli for the other consistencies regarding hyoid bone displacement, pharyngeal transit time, and the penetration and aspiration scale.

Conclusion: In elderly people with Alzheimer's dementia, neuromuscular electrical stimulation at the motor level generated a reduction in hyoid bone displacement during swallowing of food with pudding consistency, with no effects on pharyngeal transit time or swallowing safety.

Introduction: Vocal cord paralysis (VCP) is a deprivation of motility and the dysfunction of the vocal cords due to a defect in the vagal nerve or recurrent laryngeal nerve (RLN). It also occurs due to mutilation in the cricoarytenoid joint or posterior commissure scarring after prolonged tracheal intubation. It is a disorder with an extensive range of etiologies reliant on its laterality pattern.

Objective: To discuss the laterality pattern of VCP due to endotracheal intubation and its respective treatments, the associated etiologies, and the risk factors, to provide a new direction to physicians for its treatment and to avoid its occurrence.

Data synthesis: We conducted a peer review of many of the articles published to date on VCP. An analysis of 967 patients from 5 studies determined that unilateral VCP (UVCP) is three times more frequent than bilateral VCP (BVCP). Furthermore, we analyzed 2,232 patients from 6 different studies that concluded surgery was the most common cause, followed by neoplastic diseases or malignancies. Another important though highly uncommon etiology of VCP is endotracheal intubation; however, it is disturbing for doctors as endotracheal intubation is a common procedure for general anesthesia.

Conclusion: A variety of factors may cause VCP, including age, comorbidities, body mass index BMI, the duration of the intubation, the handling of the apparatus, operative time, and tracheal tube sizes. Preventive measures should be prioritized to avoid severe consequences, and intubation must be performed carefully in elderly people and in subjects with lower BMIs. Knowledge of the risk factors will help physicians customize intubation procedures in the future.

Introduction  Radiotherapy is the primary treatment for nasopharyngeal carcinoma. Radiation exposure to the cochlea and middle ear can cause hearing loss. Objective  To develop a multivariable normal tissue complication probability (NTCP) model to predict the risk of hearing impairment in nasopharyngeal cancer patients based on clinical and radiation dosimetry features and to identify the key factors associated with hearing loss. Methods  A retrospective review of 229 patients was conducted. We recorded the audiometry and presence of middle ear effusion (MEE) and compared findings before and after therapy. The factors included age, gender, signs and symptoms at presentation, tumor staging, prescribed dose at the tumor and high-risk nodal region, cochlea, and concurrent chemotherapy treatment. The model was formulated using multivariate logistic regression. Results  Age of more than 50 years, high primary staging, and dose at the cochlea > 43 Gy were major risk factors for sensorineural hearing loss. The final NTCP model for hearing loss comprised age and cochlea dose with an area under the curve (AUC) of 0.644; the predicted risk ranged from 15.84 to 44.52%. Locally advanced disease and cochlea dose greater than 44 Gy were risk factors for MEE; the predicted risk ranged from 20.42 to 51.99%. Conclusion  Age over 50, T stages 3 and 4, and > 43 Gy dose to the cochlea were significantly associated with an increased risk of sensorineural hearing loss and MEE. The developed NTCP model provides information to predict these risks, aiding in treatment planning and decision-making to avoid complications.

Introduction  Stuttering is a human communication disorder characterized by involuntary interruptions to speech flow. Electrophysiological tests and behavioral evaluations allow the neuroaudiological processes involved in stuttering to be investigated. Objective  To investigate group differences in the central auditory system using long-latency auditory evoked potentials, cognitive potentials, and behavioral assessments in children who stutter and compare them with fluent children. Methods  We assessed 18 children with stuttering and compared them with a control group of 18 children without speech or language impairment. All children were evaluated with pure tone and speech audiometry, acoustic immittance measures, brainstem auditory evoked potentials, long latency auditory evoked potentials, cognitive potentials, and behavioral tests of auditory processing - Random Gap Detection Test (RGDT), Dichotic Digit Test (DDT); Duration Pattern Test (DPT); Pediatric Speech Intelligibility (PSI); and Masking Level Difference (MLD). The Scale of Auditory Behaviors (SAB) questionnaire was also applied. Results  Children who stuttered had longer latencies of the P2 and P3 waves compared with the fluent group. There was no difference in P2 amplitudes, but there was a smaller P3 amplitude in children who stuttered, and they also showed significant alterations in the DDT and DPT. Furthermore, an association was found between increased P2 and P3 latency and SAB scores. Conclusion  The present study indicates that children who stutter tend to have decreased auditory ability in terms of central auditory processing, and this shows up psychophysically and on the SAB questionnaire.