Pub Date : 2024-02-05eCollection Date: 2024-01-01DOI: 10.1055/s-0043-1777450
Andro Košec, Ana Gašić, Filip Hergešić, Ivan Rašić, Vesna Košec, Vladimir Bedeković
Introduction The most common postoperative complication of total thyroidectomy is hypocalcemia, usually monitored using serum parathyroid hormone and calcium values. Objective To identify the most accurate predictors of hypocalcemia, construct a risk assesment algorithm and analyze the impact of using several calcium correction formulas in practice. Methods A prospective, single-center, non-randomized longitudinal cohort study on 205 patients undergoing total thyroidectomy. Parathyroid hormone, serum, and ionized calcium were sampled post-surgery, with the presence of symptomatic or laboratory-verified asymptomatic hypocalcemia designated as primary outcome measures. Results Parathyroid hormone sampled on the first postoperative day was the most sensitive predictor of symptomatic hypocalcemia development (sensitivity 80.22%, cut-off value ≤2.03 pmol/L). A combination of serum calcium and parathyroid concentration sampled on the first postoperative day predicted the development of hypocalcemia during recovery with the highest sensitivity and specificity (94% sensitivity, cut-off ≤2.1 mmol/L, and 89% specificity, cut-off ≤1.55 pmol/L, respectively). The use of algorithms and correction formulas did not improve the accuracy of predicting symptomatic or asymptomatic hypocalcemia. Conclusions The most sensitive predictor of symptomatic hypocalcemia present on the fifth postoperative day was PTH sampled on the first postoperative day. The need for algorithms and correction formulas is limited.
{"title":"Assessing Symptomatic Hypocalcemia Risk After Total Thyroidectomy: A Prospective Study.","authors":"Andro Košec, Ana Gašić, Filip Hergešić, Ivan Rašić, Vesna Košec, Vladimir Bedeković","doi":"10.1055/s-0043-1777450","DOIUrl":"10.1055/s-0043-1777450","url":null,"abstract":"<p><p><b>Introduction</b> The most common postoperative complication of total thyroidectomy is hypocalcemia, usually monitored using serum parathyroid hormone and calcium values. <b>Objective</b> To identify the most accurate predictors of hypocalcemia, construct a risk assesment algorithm and analyze the impact of using several calcium correction formulas in practice. <b>Methods</b> A prospective, single-center, non-randomized longitudinal cohort study on 205 patients undergoing total thyroidectomy. Parathyroid hormone, serum, and ionized calcium were sampled post-surgery, with the presence of symptomatic or laboratory-verified asymptomatic hypocalcemia designated as primary outcome measures. <b>Results</b> Parathyroid hormone sampled on the first postoperative day was the most sensitive predictor of symptomatic hypocalcemia development (sensitivity 80.22%, cut-off value ≤2.03 pmol/L). A combination of serum calcium and parathyroid concentration sampled on the first postoperative day predicted the development of hypocalcemia during recovery with the highest sensitivity and specificity (94% sensitivity, cut-off ≤2.1 mmol/L, and 89% specificity, cut-off ≤1.55 pmol/L, respectively). The use of algorithms and correction formulas did not improve the accuracy of predicting symptomatic or asymptomatic hypocalcemia. <b>Conclusions</b> The most sensitive predictor of symptomatic hypocalcemia present on the fifth postoperative day was PTH sampled on the first postoperative day. The need for algorithms and correction formulas is limited.</p>","PeriodicalId":13731,"journal":{"name":"International Archives of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10843930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05eCollection Date: 2024-01-01DOI: 10.1055/s-0043-1767795
Patrick O McGarey, Osama Hamdi, Lane Donaldson, Kevin Zhan, Edwin F Crandley, David D Wilson, Austin J Sim, Paul W Read, Jonathan C Garneau, Katherine L Fedder, David C Shonka, Mark J Jameson
Introduction Human papillomavirus-related (HPV + ) oropharyngeal squamous cell carcinoma (OPSCC) is increasing in incidence and presents diagnostic challenges given its unique clinical presentation. Objective The purpose of the present study is to characterize the impact of the unique clinical presentation of HPV-related OPSCC on delays in diagnosis. Methods Retrospective review of presenting symptoms and clinical characteristics of 284 patients with OPSCC treated from 2002-2014. Delay in diagnosis was defined as the presence of any of the following: multiple non-diagnostic fine needle aspirate (FNA) biopsies; two or more courses of antibiotic therapy; surgery with incorrect preoperative diagnosis; evaluation by an otolaryngologist without further workup; or surgery without definitive postoperative diagnosis. Results p16+ tumors demonstrated a distinct clinical presentation that more commonly involved a neck mass (85.1% versus 57.3% of p16-; p < 0.001) and less frequently included odynophagia (24.6% versus 51.7% of p16-; p < 0.001). Patients who experienced diagnostic delay were more likely to have p16+ tumors (77.7% delayed versus 62.8% not delayed; p = 0.006). p16+ primary tumors were more likely to be undetectable by physical examination of the head and neck including flexible laryngoscopy (19.0% versus 6.7% of p16-; p = 0.007) and more frequently associated with nondiagnostic FNA biopsies of a cervical nodal mass (11.8% versus 3.4% of p16-, p = 0.03). Conclusions Compared with non-HPV related OPSCC, the unique clinical presentation and characteristics of HPV+ OPSCC are associated with an increased incidence of diagnostic delay. Targeted education of appropriate care providers may improve time to diagnosis and treatment.
{"title":"Diagnostic Delay in HPV-Related Oropharyngeal Squamous Cell Carcinoma.","authors":"Patrick O McGarey, Osama Hamdi, Lane Donaldson, Kevin Zhan, Edwin F Crandley, David D Wilson, Austin J Sim, Paul W Read, Jonathan C Garneau, Katherine L Fedder, David C Shonka, Mark J Jameson","doi":"10.1055/s-0043-1767795","DOIUrl":"10.1055/s-0043-1767795","url":null,"abstract":"<p><p><b>Introduction</b> Human papillomavirus-related (HPV + ) oropharyngeal squamous cell carcinoma (OPSCC) is increasing in incidence and presents diagnostic challenges given its unique clinical presentation. <b>Objective</b> The purpose of the present study is to characterize the impact of the unique clinical presentation of HPV-related OPSCC on delays in diagnosis. <b>Methods</b> Retrospective review of presenting symptoms and clinical characteristics of 284 patients with OPSCC treated from 2002-2014. Delay in diagnosis was defined as the presence of any of the following: multiple non-diagnostic fine needle aspirate (FNA) biopsies; two or more courses of antibiotic therapy; surgery with incorrect preoperative diagnosis; evaluation by an otolaryngologist without further workup; or surgery without definitive postoperative diagnosis. <b>Results</b> p16+ tumors demonstrated a distinct clinical presentation that more commonly involved a neck mass (85.1% versus 57.3% of p16-; <i>p</i> < 0.001) and less frequently included odynophagia (24.6% versus 51.7% of p16-; <i>p</i> < 0.001). Patients who experienced diagnostic delay were more likely to have p16+ tumors (77.7% delayed versus 62.8% not delayed; <i>p</i> = 0.006). p16+ primary tumors were more likely to be undetectable by physical examination of the head and neck including flexible laryngoscopy (19.0% versus 6.7% of p16-; <i>p</i> = 0.007) and more frequently associated with nondiagnostic FNA biopsies of a cervical nodal mass (11.8% versus 3.4% of p16-, <i>p</i> = 0.03). <b>Conclusions</b> Compared with non-HPV related OPSCC, the unique clinical presentation and characteristics of HPV+ OPSCC are associated with an increased incidence of diagnostic delay. Targeted education of appropriate care providers may improve time to diagnosis and treatment.</p>","PeriodicalId":13731,"journal":{"name":"International Archives of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10843923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05eCollection Date: 2024-01-01DOI: 10.1055/s-0043-1777419
Uma Pokala, Shilpa Potnuru, Sasikala Kanapalli, Agni Vishnu Sailesh, Naveen P
Introduction Some common symptoms of coronavirus disease 2019 (COVID-19) are fever, cough, and shortness of breath. But ear, nose, and throat (ENT) manifestations such as loss of smell and taste are also very common. Objectives To compare the general and otorhinolaryngological manifestations of COVID-19 and to compare the treatments given and mortality rate during its two waves. Methods This retrospective study was conducted on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in a tertiary care teaching hospital. Six hundred patients were included in the 1st wave sample and 516 were in the 2nd wave sample. The data collected included demographics, comorbidities, general, and ENT symptoms, need for ventilatory support, oxygen therapy, and mortality for both the waves. Results Fever, malaise, and myalgia were more frequently presented in the first wave than in the second, whereas shortness of breath was more common in the second wave. In the second wave, a significant increase in anosmia cases was reported, whereas sore throat, nasal obstruction, dysphagia, nasal discharge, and sneezing were significantly reduced compared with the first wave ( p < 0.001). The case fatality rate increased from 11.33 to 21.55% ( p < 0.001) from the 1 st to the 2 nd wave. The patients who died in the second wave were younger than those in the first wave. Two doses of vaccination showed protection from the death over those not vaccinated and those who only received one dose ( p < 0.05). Conclusion Ear, nose, and throat (ENT) manifestations are very common along with the general symptoms. As anosmia and dysgeusia are early presenting symptoms in COVID-19 patients, all physicians should screen patients for ENT symptoms.
导言 2019 年冠状病毒病(COVID-19)的一些常见症状是发烧、咳嗽和呼吸急促。但耳鼻喉科(ENT)的表现也很常见,如嗅觉和味觉丧失。目的 比较 COVID-19 的一般表现和耳鼻喉科表现,并比较两次发病期间的治疗方法和死亡率。方法 该回顾性研究针对一家三级教学医院的严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)病例。第一波样本包括 600 名患者,第二波样本包括 516 名患者。收集的数据包括人口统计学、合并症、全身症状、耳鼻喉科症状、呼吸机支持需求、氧疗以及两波样本的死亡率。结果 第一波比第二波更常见发热、乏力和肌痛,而第二波更常见呼吸急促。在第二波中,无嗅病例明显增加,而咽喉痛、鼻塞、吞咽困难、流鼻涕和打喷嚏的病例与第一波相比明显减少(p p st 至第二波)。第二波接种后死亡的患者比第一波接种后死亡的患者年轻。接种两剂疫苗后,与未接种疫苗者和只接种一剂疫苗者相比,接种两剂疫苗的患者可避免死亡。由于嗅觉障碍和味觉障碍是 COVID-19 患者的早期症状,所有医生都应筛查患者的耳鼻喉症状。
{"title":"A Comparative Study on the General and Otolaryngological Manifestations of COVID-19 in the Hospitalized Population of the Telangana Region During the First and Second Waves.","authors":"Uma Pokala, Shilpa Potnuru, Sasikala Kanapalli, Agni Vishnu Sailesh, Naveen P","doi":"10.1055/s-0043-1777419","DOIUrl":"10.1055/s-0043-1777419","url":null,"abstract":"<p><p><b>Introduction</b> Some common symptoms of coronavirus disease 2019 (COVID-19) are fever, cough, and shortness of breath. But ear, nose, and throat (ENT) manifestations such as loss of smell and taste are also very common. <b>Objectives</b> To compare the general and otorhinolaryngological manifestations of COVID-19 and to compare the treatments given and mortality rate during its two waves. <b>Methods</b> This retrospective study was conducted on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in a tertiary care teaching hospital. Six hundred patients were included in the 1st wave sample and 516 were in the 2nd wave sample. The data collected included demographics, comorbidities, general, and ENT symptoms, need for ventilatory support, oxygen therapy, and mortality for both the waves. <b>Results</b> Fever, malaise, and myalgia were more frequently presented in the first wave than in the second, whereas shortness of breath was more common in the second wave. In the second wave, a significant increase in anosmia cases was reported, whereas sore throat, nasal obstruction, dysphagia, nasal discharge, and sneezing were significantly reduced compared with the first wave ( <i>p</i> < 0.001). The case fatality rate increased from 11.33 to 21.55% ( <i>p</i> < 0.001) from the 1 <sup>st</sup> to the 2 <sup>nd</sup> wave. The patients who died in the second wave were younger than those in the first wave. Two doses of vaccination showed protection from the death over those not vaccinated and those who only received one dose ( <i>p</i> < 0.05). <b>Conclusion</b> Ear, nose, and throat (ENT) manifestations are very common along with the general symptoms. As anosmia and dysgeusia are early presenting symptoms in COVID-19 patients, all physicians should screen patients for ENT symptoms.</p>","PeriodicalId":13731,"journal":{"name":"International Archives of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10843908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05eCollection Date: 2024-04-01DOI: 10.1055/s-0043-1776731
Ghady Dhafer Alshehri, Ahlam Ahmed Almahmoudi, Afnan Abdullah Alsaif, Bashayer Hassan Shalabi, Hana Zuhair Fatani, Fatima Hassan Aljassas, Dania Wazen Alsulami, Faris Alhejaili, Faisal Zawawi
Introduction Appropriate quality and quantity of sleep are critical for good mental health, optimal body functioning, memory consolidation, and other cognitive processes. Objectives To evaluate the sleeping patterns of medical students in Saudi Arabia and their relationships with psychological distress. Methods This was a cross-sectional, self-administered, questionnaire-based study. The study included medical students from a university in Jeddah, Saudi Arabia. The Pittsburgh Sleep Quality Index (PSQI) and the Athens Insomnia Scale (AIS) were used to evaluate the prevalence and burden of inadequate sleep quality and insomnia in the participants. Results The majority of the participants was women (76.6%). Furthermore, most participants (96.2%) were aged between 18 and 24 years old, while 54.4% of the participants were in their senior year. According to the AIS scores (mean: 15.85 ± 4.52), 98.7% of the participants exhibited insomnia symptoms. The PSQI scores (mean: 9.53 ± 5.67) revealed that 70.5% of the participants had poor sleep quality. Students in their fundamental and junior years had significantly higher percentages of insomnia symptoms and poor sleep quality compared with students in their senior years. Conclusion The prevalence of insomnia and poor sleep quality is high among medical students. Therefore, appropriate strategies for early detection and intervention are warranted.
{"title":"Sleep Patterns and Associated Insomnia in Junior and Senior Medical Students: A Questionnaire-Based Cross-Sectional Study.","authors":"Ghady Dhafer Alshehri, Ahlam Ahmed Almahmoudi, Afnan Abdullah Alsaif, Bashayer Hassan Shalabi, Hana Zuhair Fatani, Fatima Hassan Aljassas, Dania Wazen Alsulami, Faris Alhejaili, Faisal Zawawi","doi":"10.1055/s-0043-1776731","DOIUrl":"https://doi.org/10.1055/s-0043-1776731","url":null,"abstract":"<p><p><b>Introduction</b> Appropriate quality and quantity of sleep are critical for good mental health, optimal body functioning, memory consolidation, and other cognitive processes. <b>Objectives</b> To evaluate the sleeping patterns of medical students in Saudi Arabia and their relationships with psychological distress. <b>Methods</b> This was a cross-sectional, self-administered, questionnaire-based study. The study included medical students from a university in Jeddah, Saudi Arabia. The Pittsburgh Sleep Quality Index (PSQI) and the Athens Insomnia Scale (AIS) were used to evaluate the prevalence and burden of inadequate sleep quality and insomnia in the participants. <b>Results</b> The majority of the participants was women (76.6%). Furthermore, most participants (96.2%) were aged between 18 and 24 years old, while 54.4% of the participants were in their senior year. According to the AIS scores (mean: 15.85 ± 4.52), 98.7% of the participants exhibited insomnia symptoms. The PSQI scores (mean: 9.53 ± 5.67) revealed that 70.5% of the participants had poor sleep quality. Students in their fundamental and junior years had significantly higher percentages of insomnia symptoms and poor sleep quality compared with students in their senior years. <b>Conclusion</b> The prevalence of insomnia and poor sleep quality is high among medical students. Therefore, appropriate strategies for early detection and intervention are warranted.</p>","PeriodicalId":13731,"journal":{"name":"International Archives of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11008932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05eCollection Date: 2024-04-01DOI: 10.1055/s-0043-1777448
Henrique de Paula Bedaque, Emerson Kennedy Ribeiro de Andrade Filho, Caio de Oliveira Rabelo, José Eduardo Nóbrega Moura, Kelvin Leite Moura, José Diniz Junior, Maria Luisa Nobre Medeiros E Silva Guimarães
Introduction Smell is one of the senses of the human body, and it can be affected by several factors, such as viral infections, traumatic brain injury, iatrogenesis, smoking, and neurodegenerative and systemic diseases. Objectives The main goal of the present study is to describe the epidemiology of olfactory disorders in Rio Grande do Norte (RN). More specifically, to determine the prevalence of olfactory dysfunction and to identify the main risk factors related to these dysfunctions in the state's population. Methods A total of 180 volunteers living in the RN underwent the Connecticut Clinical Research Center (CCCRC) smell test and a clinical and demographic questionnaire. Results A total of 58.89% of the patients presented normosmia and 87.78% were classified as having between normal and mild hyposmia. A statistically significant relationship was found between worse performance in the test and nasal surgery ( p = 0.041) and the subjective feeling of not having an accurate sense of smell ( p = 0.006 on the right nostril). There was no statistical relationship between the olfactory status and the report of coronavirus disease 2019 (COVID-19) infection ( p = 0.254). Conclusion The occurrence of altered sense of smell in our study was different from that reported in other studies that used the same test. The relationship with COVID-19 was not clear.
{"title":"Olfactory Dysfunction in Adults from Rio Grande do Norte: A Cross-Sectional Study.","authors":"Henrique de Paula Bedaque, Emerson Kennedy Ribeiro de Andrade Filho, Caio de Oliveira Rabelo, José Eduardo Nóbrega Moura, Kelvin Leite Moura, José Diniz Junior, Maria Luisa Nobre Medeiros E Silva Guimarães","doi":"10.1055/s-0043-1777448","DOIUrl":"https://doi.org/10.1055/s-0043-1777448","url":null,"abstract":"<p><p><b>Introduction</b> Smell is one of the senses of the human body, and it can be affected by several factors, such as viral infections, traumatic brain injury, iatrogenesis, smoking, and neurodegenerative and systemic diseases. <b>Objectives</b> The main goal of the present study is to describe the epidemiology of olfactory disorders in Rio Grande do Norte (RN). More specifically, to determine the prevalence of olfactory dysfunction and to identify the main risk factors related to these dysfunctions in the state's population. <b>Methods</b> A total of 180 volunteers living in the RN underwent the Connecticut Clinical Research Center (CCCRC) smell test and a clinical and demographic questionnaire. <b>Results</b> A total of 58.89% of the patients presented normosmia and 87.78% were classified as having between normal and mild hyposmia. A statistically significant relationship was found between worse performance in the test and nasal surgery ( <i>p</i> = 0.041) and the subjective feeling of not having an accurate sense of smell ( <i>p</i> = 0.006 on the right nostril). There was no statistical relationship between the olfactory status and the report of coronavirus disease 2019 (COVID-19) infection ( <i>p</i> = 0.254). <b>Conclusion</b> The occurrence of altered sense of smell in our study was different from that reported in other studies that used the same test. The relationship with COVID-19 was not clear.</p>","PeriodicalId":13731,"journal":{"name":"International Archives of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11008930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Lips play a fundamental role in facial attractiveness and in decisions pertaining to orthognathic surgery. Objective To assess the upper lip changes following Le Fort I osteotomy for maxillary advancement and/or impaction. Methods In the present retrospective non-randomized clinical trial, we evaluated 3 groups of patients who underwent Le Fort I osteotomy of the maxilla. Group 1 (n = 35) underwent maxillary advancement, group 2 (n = 14), maxillary impaction, and group 3 (n = 11) was submitted to both maxillary advancement and impaction. The lip thickness of all patients was measured preoperatively, and the participants in each group were categorized into two subgroups: thin (< 12 mm) and thick (> 12 mm) lip. The primary (before orthognathic surgery) and final (after orthodontic bracket removal) lateral cephalograms of the patients were analyzed using the Dolphin software. Comparisons were made using the paired t -test and linear regression in the IBM SPSS Statistics for Windows software. Results The length of the upper lip increased by 1 mm ( p = 0.012) on average following maxillary advancement, and it decreased by 0.43 mm ( p = 0.24) on average following maxillary impaction. In the maxillary advancement group, the change in angulation of the incisors predicted the incisal display ( p = 0.03). In the maxillary impaction group, skeletal changes in the vertical dimension predicted changes in upper lip length ( p = 0.033). Conclusions Le Fort I osteotomy for maxillary advancement significantly increases the length of the upper lip. The assessment of lip thickness prior to surgery can help predict the postoperative results. Changing the angulation of the incisors can predict the incisal display. In maxillary impaction, skeletal changes in the vertical dimension can predict the changes in the length of the upper lip.
引言 嘴唇对面部吸引力和正颌外科手术的决定起着至关重要的作用。目的 评估因上颌骨前移和/或阻塞而接受 Le Fort I 截骨术后上唇的变化。方法 在本回顾性非随机临床试验中,我们对 3 组接受 Le Fort I 上颌骨截骨术的患者进行了评估。第一组(35 人)接受上颌前移术,第二组(14 人)接受上颌阻滞术,第三组(11 人)同时接受上颌前移术和上颌阻滞术。术前测量了所有患者的嘴唇厚度,并将每组患者分为薄唇(< 12 毫米)和厚唇(> 12 毫米)两组。使用 Dolphin 软件对患者的初次(正颌手术前)和最终(正畸托槽移除后)侧向头影进行分析。在 IBM SPSS Statistics for Windows 软件中使用配对 t 检验和线性回归进行比较。结果 上颌骨前移术后,上唇长度平均增加了 1 毫米(p = 0.012),而上颌骨阻塞术后,上唇长度平均减少了 0.43 毫米(p = 0.24)。在上颌前突组中,切牙角度的变化可以预测切迹的显示 ( p = 0.03)。在上颌阻塞组,垂直维度的骨骼变化可预测上唇长度的变化 ( p = 0.033)。结论 用于上颌前突的 Le Fort I 截骨术可显著增加上唇长度。术前对嘴唇厚度的评估有助于预测术后效果。改变切牙的角度可以预测切口的显示效果。在上颌阻塞术中,垂直维度的骨骼变化可以预测上唇长度的变化。
{"title":"Effects of Maxillary Movements on Lips Following Orthognathic Surgery: A Retrospective Non-Randomized Clinical Trial.","authors":"Soodeh Tahmasbi, Kasra Rahimipour, Mahshid Namdari, Reza Tabrizi, Fatemesadat Seyedzadeghomi","doi":"10.1055/s-0043-1773759","DOIUrl":"10.1055/s-0043-1773759","url":null,"abstract":"<p><p><b>Introduction</b> Lips play a fundamental role in facial attractiveness and in decisions pertaining to orthognathic surgery. <b>Objective</b> To assess the upper lip changes following Le Fort I osteotomy for maxillary advancement and/or impaction. <b>Methods</b> In the present retrospective non-randomized clinical trial, we evaluated 3 groups of patients who underwent Le Fort I osteotomy of the maxilla. Group 1 (n = 35) underwent maxillary advancement, group 2 (n = 14), maxillary impaction, and group 3 (n = 11) was submitted to both maxillary advancement and impaction. The lip thickness of all patients was measured preoperatively, and the participants in each group were categorized into two subgroups: thin (< 12 mm) and thick (> 12 mm) lip. The primary (before orthognathic surgery) and final (after orthodontic bracket removal) lateral cephalograms of the patients were analyzed using the Dolphin software. Comparisons were made using the paired <i>t</i> -test and linear regression in the IBM SPSS Statistics for Windows software. <b>Results</b> The length of the upper lip increased by 1 mm ( <i>p</i> = 0.012) on average following maxillary advancement, and it decreased by 0.43 mm ( <i>p</i> = 0.24) on average following maxillary impaction. In the maxillary advancement group, the change in angulation of the incisors predicted the incisal display ( <i>p</i> = 0.03). In the maxillary impaction group, skeletal changes in the vertical dimension predicted changes in upper lip length ( <i>p</i> = 0.033). <b>Conclusions</b> Le Fort I osteotomy for maxillary advancement significantly increases the length of the upper lip. The assessment of lip thickness prior to surgery can help predict the postoperative results. Changing the angulation of the incisors can predict the incisal display. In maxillary impaction, skeletal changes in the vertical dimension can predict the changes in the length of the upper lip.</p>","PeriodicalId":13731,"journal":{"name":"International Archives of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10843920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction The outbreak of COVID-19 has produced an unprecedented number of trials and articles. Objective To study the impact of the COVID-19 pandemic on otolaryngology-head and neck surgery (ORL-HNS) journal processing times. Methods Original papers search of published in selected ORL-HNS journals in terms of times from submission-to-acceptance (S-A), acceptance-to-first online publication (A-P), and submission-to-online publication (S-P). Papers were divided into those published in the pre-COVID-19 era and those during the COVID-19 era. The latter were further divided into unrelated to COVID-19 and related to COVID-19. Results A total of 487 articles from 5 selected ORL-HNS journals were included, of which 236 (48.5%) were published during the pre-COVID-19 era and 251 (51.5%) were published during the COVID-19 era. Among them, 180 (37%) papers were not related to COVID-19, and 71 (14.5%) were related to COVID-19. The S-A duration of COVID-19-related articles was significantly shorter compared with that of papers submitted in the pre-COVID-19 era and to papers submitted in the COVID-19 era but unrelated to COVID-19 (median 6 to 34 days compared to 65 to 125 and 46 to 127, respectively) in all 5 journals. The most prominent reductions in S-A and S-P times were documented in the laryngology and otology/neurotology disciplines, respectively. Conclusions Processing times of the included papers were significantly shorter in most of the selected ORL-HNS journals during the COVID-19 era compared with the pre-COVID-19 era. COVID-19-related papers were processed more rapidly than non-COVID-19-related papers. These findings testify to the possibility of markedly expediting S-P times and hopefully set a precedent for postpandemic publishing schedules. Level Of Evidence: 5.
{"title":"Fast-Tracking of Publication Times of Otolaryngology Papers During the COVID-19 Pandemic.","authors":"Irit Duek, Nidal Muhanna, Yahav Oron, Yohai Shraga, Omer J Ungar","doi":"10.1055/s-0043-1767806","DOIUrl":"10.1055/s-0043-1767806","url":null,"abstract":"<p><p><b>Introduction</b> The outbreak of COVID-19 has produced an unprecedented number of trials and articles. <b>Objective</b> To study the impact of the COVID-19 pandemic on otolaryngology-head and neck surgery (ORL-HNS) journal processing times. <b>Methods</b> Original papers search of published in selected ORL-HNS journals in terms of times from submission-to-acceptance (S-A), acceptance-to-first online publication (A-P), and submission-to-online publication (S-P). Papers were divided into those published in the pre-COVID-19 era and those during the COVID-19 era. The latter were further divided into unrelated to COVID-19 and related to COVID-19. <b>Results</b> A total of 487 articles from 5 selected ORL-HNS journals were included, of which 236 (48.5%) were published during the pre-COVID-19 era and 251 (51.5%) were published during the COVID-19 era. Among them, 180 (37%) papers were not related to COVID-19, and 71 (14.5%) were related to COVID-19. The S-A duration of COVID-19-related articles was significantly shorter compared with that of papers submitted in the pre-COVID-19 era and to papers submitted in the COVID-19 era but unrelated to COVID-19 (median 6 to 34 days compared to 65 to 125 and 46 to 127, respectively) in all 5 journals. The most prominent reductions in S-A and S-P times were documented in the laryngology and otology/neurotology disciplines, respectively. <b>Conclusions</b> Processing times of the included papers were significantly shorter in most of the selected ORL-HNS journals during the COVID-19 era compared with the pre-COVID-19 era. COVID-19-related papers were processed more rapidly than non-COVID-19-related papers. These findings testify to the possibility of markedly expediting S-P times and hopefully set a precedent for postpandemic publishing schedules. Level Of Evidence: 5.</p>","PeriodicalId":13731,"journal":{"name":"International Archives of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10843905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05eCollection Date: 2024-10-01DOI: 10.1055/s-0044-1779010
Rogério Aparecido Dedivitis, Leandro Luongo de Matos, Mario Augusto Ferrari Castro, Sílvia Migueis Picado Petrarolha, Luiz Paulo Kowalski
Introduction The harmonic scalpel (HS) is a technique introduced to reduce blood loss and intraoperative time during neck dissection (ND). Objective To compare the results of HS with traditional hemostasis in ND through a systematic review and metanalysis. Methods A computer-based strategy of systematic literature survey included research in the MEDLINE, EMBASE, and Cochrane Library databases from January 2007 up to August 2022. The survey strategy employed was [harmonic scalpel OR ultrasonic scalpel] AND neck dissection. Results There were 61 articles identified that addressed the use of HS in patients undergoing ND. From those, 10 randomized clinical trials were selected, comprising 264 cases of ND using HS and 262 cases of ND without HS. Conclusion The use of HS for ND significantly reduces the operative time, intraoperative bleeding, volume of draining fluid, and the number of ligatures.
{"title":"Neck Dissection with Harmonic Instruments and Electrocautery: A Systematic Review.","authors":"Rogério Aparecido Dedivitis, Leandro Luongo de Matos, Mario Augusto Ferrari Castro, Sílvia Migueis Picado Petrarolha, Luiz Paulo Kowalski","doi":"10.1055/s-0044-1779010","DOIUrl":"10.1055/s-0044-1779010","url":null,"abstract":"<p><p><b>Introduction</b> The harmonic scalpel (HS) is a technique introduced to reduce blood loss and intraoperative time during neck dissection (ND). <b>Objective</b> To compare the results of HS with traditional hemostasis in ND through a systematic review and metanalysis. <b>Methods</b> A computer-based strategy of systematic literature survey included research in the MEDLINE, EMBASE, and Cochrane Library databases from January 2007 up to August 2022. The survey strategy employed was [harmonic scalpel OR ultrasonic scalpel] AND neck dissection. <b>Results</b> There were 61 articles identified that addressed the use of HS in patients undergoing ND. From those, 10 randomized clinical trials were selected, comprising 264 cases of ND using HS and 262 cases of ND without HS. <b>Conclusion</b> The use of HS for ND significantly reduces the operative time, intraoperative bleeding, volume of draining fluid, and the number of ligatures.</p>","PeriodicalId":13731,"journal":{"name":"International Archives of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11511277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05eCollection Date: 2024-07-01DOI: 10.1055/s-0043-1778015
Rachana M Prajapati, Jayman B Raval, Ranjan G Aiyer
Introduction The presence of foreign bodies in the airways remain a diagnostic challenge to healthcare professionals. They can become life threatening emergencies that require immediate intervention or go unnoticed for weeks and even months. Prevention is best but early recognition remains a critical factor in treatment of foreign body inhalation in children. Objective To study the diagnostic advantages of virtual over rigid bronchoscopy in the evaluation of children with suspected foreign body in the tracheobronchial tree and plan for early management. Methods A crossectional study conducted at a tertiary care hospital & medical college in India. A total 24 patients (0-12-years-old) who presented with complaints of sudden onset of coughing, choking, and breathing difficulty were included during the 2-year duration, from January 2018 to December 2019. All patients underwent virtual and rigid bronchoscopy. Results In 8 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. There was one case in which virtual bronchoscopy showed no foreign body, but rigid bronchoscopy detected it. In 15 cases virtual and rigid bronchoscopy did not show foreign bodies. The sensitivity, specificity, positive and negative predictive value of virtual bronchoscopy were 88.88, 100, 100, and 93.75%, respectively. Conclusions Virtual bronchoscopy is less invasive and does not require general anesthesia but cost and availability are limitations. It can be used as method of investigation in children with suspected foreign body aspiration.
{"title":"Role of Virtual Bronchoscopy in Evaluation of Suspected Foreign Body in Children's Tracheobronchial Tree.","authors":"Rachana M Prajapati, Jayman B Raval, Ranjan G Aiyer","doi":"10.1055/s-0043-1778015","DOIUrl":"10.1055/s-0043-1778015","url":null,"abstract":"<p><p><b>Introduction</b> The presence of foreign bodies in the airways remain a diagnostic challenge to healthcare professionals. They can become life threatening emergencies that require immediate intervention or go unnoticed for weeks and even months. Prevention is best but early recognition remains a critical factor in treatment of foreign body inhalation in children. <b>Objective</b> To study the diagnostic advantages of virtual over rigid bronchoscopy in the evaluation of children with suspected foreign body in the tracheobronchial tree and plan for early management. <b>Methods</b> A crossectional study conducted at a tertiary care hospital & medical college in India. A total 24 patients (0-12-years-old) who presented with complaints of sudden onset of coughing, choking, and breathing difficulty were included during the 2-year duration, from January 2018 to December 2019. All patients underwent virtual and rigid bronchoscopy. <b>Results</b> In 8 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. There was one case in which virtual bronchoscopy showed no foreign body, but rigid bronchoscopy detected it. In 15 cases virtual and rigid bronchoscopy did not show foreign bodies. The sensitivity, specificity, positive and negative predictive value of virtual bronchoscopy were 88.88, 100, 100, and 93.75%, respectively. <b>Conclusions</b> Virtual bronchoscopy is less invasive and does not require general anesthesia but cost and availability are limitations. It can be used as method of investigation in children with suspected foreign body aspiration.</p>","PeriodicalId":13731,"journal":{"name":"International Archives of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11226272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05eCollection Date: 2024-01-01DOI: 10.1055/s-0043-1767676
Soultana L Papadopoulou, Evangelia Kitsanou, Ermioni Brahimi, Georgios Papathanakos, Ioannis Andrianopoulos, Stavroula J Theodorou, Vasilios Koulouras, Nafsica Ziavra
Introduction Dysphagia is a significant but underrecognized clinical issue in the intensive care unit (ICU), and it is associated with various complications. Despite its clinical importance, there is limited research and no Greek ICU-specific guidelines for managing dysphagic patients. Additionally, only a few ICUs in Greece have dysphagia specialists, specifically speech-language pathologists (SLPs) providing their expertise. Objective Τo identify the current practices for dysphagia management (screening, assessment, treatment) and gain insight into ICU directors' awareness/perceptions of the prevalence, complications, and risk of dysphagia. Materials and Methods We identified 138 Greek ICUs. Data were collected from ICU (including pediatric and neonatal) directors, working in public and private hospitals, via a 24-item, anonymous online questionnaire, within a 4-month period. Results Our survey was completed by 45 ICU directors. Most participants (84.4%) reported that dysphagia is a relevant clinical problem in their ICU, and 51.1% estimated a frequency rate < 20%. Non-instrumental approaches are mainly utilized to screen and diagnose dysphagia, whereas enteral nutrition and diet modifications are used to manage dysphagia. Additionally, 64.4% of ICU directors agreed that SLPs are essential for the management of dysphagic patients, and 66.7%, that awareness of dysphagia in their ICU could be increased. Conclusion The current study documented the methods and approaches used to manage dysphagic patients in Greek ICUs. The ICU directors seem to recognize the clinical significance of dysphagia and its complications. According to our findings, the employment of SLPs could result in a more comprehensive and intensive approach and improve the quality of care for these patients.
{"title":"Evaluation and Treatment of Dysphagia in Public and Private Intensive Care Units (ICUs) in Greece.","authors":"Soultana L Papadopoulou, Evangelia Kitsanou, Ermioni Brahimi, Georgios Papathanakos, Ioannis Andrianopoulos, Stavroula J Theodorou, Vasilios Koulouras, Nafsica Ziavra","doi":"10.1055/s-0043-1767676","DOIUrl":"10.1055/s-0043-1767676","url":null,"abstract":"<p><p><b>Introduction</b> Dysphagia is a significant but underrecognized clinical issue in the intensive care unit (ICU), and it is associated with various complications. Despite its clinical importance, there is limited research and no Greek ICU-specific guidelines for managing dysphagic patients. Additionally, only a few ICUs in Greece have dysphagia specialists, specifically speech-language pathologists (SLPs) providing their expertise. <b>Objective</b> Τo identify the current practices for dysphagia management (screening, assessment, treatment) and gain insight into ICU directors' awareness/perceptions of the prevalence, complications, and risk of dysphagia. <b>Materials and Methods</b> We identified 138 Greek ICUs. Data were collected from ICU (including pediatric and neonatal) directors, working in public and private hospitals, via a 24-item, anonymous online questionnaire, within a 4-month period. <b>Results</b> Our survey was completed by 45 ICU directors. Most participants (84.4%) reported that dysphagia is a relevant clinical problem in their ICU, and 51.1% estimated a frequency rate < 20%. Non-instrumental approaches are mainly utilized to screen and diagnose dysphagia, whereas enteral nutrition and diet modifications are used to manage dysphagia. Additionally, 64.4% of ICU directors agreed that SLPs are essential for the management of dysphagic patients, and 66.7%, that awareness of dysphagia in their ICU could be increased. <b>Conclusion</b> The current study documented the methods and approaches used to manage dysphagic patients in Greek ICUs. The ICU directors seem to recognize the clinical significance of dysphagia and its complications. According to our findings, the employment of SLPs could result in a more comprehensive and intensive approach and improve the quality of care for these patients.</p>","PeriodicalId":13731,"journal":{"name":"International Archives of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10843924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}