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Cannabidiol (CBD): Potential Use in Otorhinolaryngology. 大麻二酚(CBD):耳鼻喉科的潜在用途。
IF 1.1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-02-05 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1777857
Geraldo Pereira Jotz, Rafael Scorsatto Ortiz, Renata Pereira Limberger, Flavio Anastácio de Oliveira Camargo
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引用次数: 0
Late Bilateral Sequential Cochlear Implant and Quality of Life. 晚期双侧序列人工耳蜗植入与生活质量
IF 1.1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-02-05 eCollection Date: 2024-04-01 DOI: 10.1055/s-0043-1776721
Larissa Claret De Lima Mendes, Alda Borges, Fernanda Caldas, Juliano Passos Barbosa, Fayez Bahmad

Introduction  Hearing impairment is one of the main disorders that can interfere with the development of speech and language. In an individual, it can cause significant communication difficulties, social isolation, negative feelings, and depressive disorders. The hearing aids (HAs) and cochlear implant (CI) are options for profound and severe hearing loss, and the CI can be indicated for individuals who do not obtain benefits from HAs. Objective  To evaluate the quality of life of individuals who underwent sequential bilateral CIs with a long surgical interval between procedures. Methods  Fifteen patients, aged 8 to 70 years old, who underwent sequential bilateral CI, with an interval ≥ 4 years between surgeries, were evaluated. Quality of life was evaluated using three questionnaires: WHOQOL-BREF, SSQ-12 and HHIA in Portuguese. Results  The WHOQOL-BREF questionnaire showed that the study participants had a good quality of life in all domains assessed. According to the SSQ-12, few reported inability to listen in communication situations. Most individuals were classified as having medium disability by the HHIA, but the social and emotional effects did not significantly affect the quality of life. Conclusion  The use of questionnaires to assess the quality of life of patients with hearing impairment is a valuable tool to measure adaptation to CI. Patients undergoing bilateral sequential CI, even with a long interval between procedures, presented high indices of quality of life.

导言 听力障碍是影响言语和语言发展的主要疾病之一。听力障碍可导致严重的沟通障碍、社交孤立、负面情绪和抑郁症。助听器(HAs)和人工耳蜗(CI)是治疗极重度和严重听力损失的选择,而人工耳蜗则适用于无法从助听器中获益的患者。目的 评估连续接受双侧人工耳蜗植入术且手术间隔时间较长的患者的生活质量。方法 对 15 名年龄在 8 至 70 岁之间、接受过连续双侧 CI 手术且手术间隔时间≥ 4 年的患者进行评估。使用三种问卷对患者的生活质量进行了评估:WHOQOL-BREF、SSQ-12 和葡萄牙语 HHIA。结果 WHOQOL-BREF 问卷显示,研究参与者在所有评估领域的生活质量都很高。根据 SSQ-12,很少有人报告在交流场合无法倾听。在 HHIA 中,大多数人被归类为中度残疾,但社交和情感方面的影响对生活质量并无明显影响。结论 使用问卷评估听力障碍患者的生活质量是衡量其对 CI 适应情况的重要工具。接受双侧顺序 CI 的患者,即使手术间隔时间较长,其生活质量指数也很高。
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引用次数: 0
Sleep and Learning: A Systematic Review. 睡眠与学习:系统回顾
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-02-05 eCollection Date: 2024-10-01 DOI: 10.1055/s-0043-1777294
Martha Lucía Gutiérrez Pérez, Juan Antonio Lugo Machado, Valeria Lozano Lavado, Diana Camila Navarro Pimiento

Introduction  Sleep deprivation has a great impact on the learning process in physicians in training. Therefore, inquiring on this phenomenon in the most recent investigations will facilitate the provision of evidence on the influence regarding the absence of sleep on the learning process in health personnel. Objectives  The aim of this systematic review is to review, analyze and discuss the current literature that shows the impact of sleep on the learning process on doctors in training. Data Synthesis  A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A search of the existing literature between the years of 2000 and 2022 was performed in the PubMed and Elsevier databases, taking into account the inclusion criteria of articles in English or Spanish and the established timeframe. As a result, 128 articles distributed in the databases were obtained and 23 articles that met the inclusion criteria were selected. Conclusion  Sleep is a fundamental factor for the consolidation, processing and functioning of memory and learning. Health professionals are a population at risk of sleep deprivation, thus it is important to take into account the effects it has on patients and health personnel.

引言 睡眠不足对受训医生的学习过程有很大影响。因此,对这一现象进行最新调查将有助于提供证据,说明睡眠不足对医务人员学习过程的影响。目的 本系统性综述旨在回顾、分析和讨论显示睡眠对受训医生学习过程影响的现有文献。数据综述 根据《系统综述和元分析首选报告项目》(PRISMA)指南进行了系统综述。我们在 PubMed 和 Elsevier 数据库中对 2000 年至 2022 年间的现有文献进行了搜索,同时考虑到英语或西班牙语文章的纳入标准和既定的时间范围。结果,共获得 128 篇分布在数据库中的文章,并筛选出 23 篇符合纳入标准的文章。结论 睡眠是巩固、处理和发挥记忆与学习功能的基本因素。医务人员是睡眠不足的高危人群,因此必须考虑到睡眠不足对患者和医务人员的影响。
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引用次数: 0
Cross-Cultural Adaptation and Validation of the Persian Version of the M. D. Anderson Dysphagia Inventory. M. D. Anderson 吞咽困难量表波斯语版的跨文化适应性和验证。
IF 1.1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-01-24 eCollection Date: 2024-04-01 DOI: 10.1055/s-0043-1776725
Fardin Sharifi, Zahra Sadat Qoreishi, Jalal Bakhtiyari, Abbas Ebadi, Mohammad Houshyari, Samira Azghandi

Introduction  Dysphagia is a common issue in patients with head and neck cancer (HNC) and is known to negatively impact their quality of life. To evaluate the impact of dysphagia on the quality of life of HNC patients, the M. D. Anderson Dysphagia Inventory (MDADI) questionnaire was developed. Objective  The present study aimed to culturally adapt and validate the MDADI for Persian-speaking individuals. The MDADI is a self-administered questionnaire designed to assess the impact of dysphagia on the quality of life of HNC patients. Methods  The original MDADI questionnaire was translated into Persian using the forward-backward method, following the guidelines of the World Health Organization (WHO) for cultural adaptation. The content validity of the Persian version, MDADI-P, was assessed by 10 speech-language pathologists using the content validity index (CVI). Seventy-five HNC patients completed the MDADI-P to evaluate its convergent validity, which was determined by comparing the results with the Short-Form 36 (SF-36) questionnaire. Internal consistency and test-retest reliability were assessed using Cronbach α coefficient and intraclass correlation (ICC), respectively. Results  The scale content validity index (S-CVI) for the MDADI-P was 0.90, indicating good content validity. The MDADI-P demonstrated satisfactory internal consistency (Cronbach α coefficient = 0.728) and test-retest reliability (ICC = 0.91). The total MDADI-P score exhibited a significant correlation with the physical and mental components of the SF-36 (0.456 and 0.349, respectively, p  < 0.05). Conclusion  The findings of the present study confirm the suitability of the MDADI-P in terms of content validity, construct validity, internal consistency, and test-retest reliability.

导言 吞咽困难是头颈癌(HNC)患者的常见问题,众所周知会对患者的生活质量产生负面影响。为了评估吞咽困难对 HNC 患者生活质量的影响,我们开发了 M. D. 安德森吞咽困难量表 (MDADI) 问卷。目的 本研究旨在对 MDADI 进行文化适应性调整,并对讲波斯语的个人进行验证。MDADI 是一份自填式问卷,旨在评估吞咽困难对 HNC 患者生活质量的影响。方法 根据世界卫生组织(WHO)的文化适应指南,采用向前向后的方法将原始 MDADI 问卷翻译成波斯语。波斯语版 MDADI-P 的内容效度由 10 位语言病理学家使用内容效度指数 (CVI) 进行评估。75 名 HNC 患者填写了 MDADI-P,以评估其收敛效度,收敛效度是通过将结果与短表 36 (SF-36) 问卷进行比较来确定的。内部一致性和重测可靠性分别采用克朗巴赫α系数和类内相关(ICC)进行评估。结果 MDADI-P 的量表内容效度指数(S-CVI)为 0.90,表明内容效度良好。MDADI-P 的内部一致性(Cronbach α coefficient = 0.728)和测试-再测可靠性(ICC = 0.91)均令人满意。MDADI-P 的总分与 SF-36 的身体和精神部分有显著的相关性(分别为 0.456 和 0.349,p 结论 本研究的结果证实了 MDADI-P 在内容效度、建构效度、内部一致性和重测可靠性方面的适用性。
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引用次数: 0
Site of Tracheostomy and Its Influence on The Surgical Outcome and Quality of Life After Tracheal Resection and Anastomosis in Patients with Tracheal Stenosis. 气管造口部位及其对气管狭窄患者气管切除和吻合术后手术效果和生活质量的影响
IF 1.1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-01-04 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1776702
Soorya Pradeep, Arun Alexander, Sivaraman Ganesan, Dharanya Gopalakrishnan Srinivasan, Akshat Kushwaha, Aparna Gopalakrishnan, Lokesh Kumar Penubarthi, Kalaiarasi Raja, Sunil Kumar Saxena

Introduction  With the advances in critical care, the incidence of post intubation tracheal stenosis is increasing. Tracheal resection and anastomosis have been the gold standard for the management of grades III and IV stenosis. Scientific evidence from the literature on the determining factors and outcomes of surgery is not well described. Objective  This study was aimed at determining the influence of tracheostoma site on the surgical outcomes and postoperative quality of life of patients undergoing tracheal resection anastomosis. Methods  Thirteen patients who underwent tracheal resection and anastomosis during a period of 3 years were followed up prospectively for 3 months to determine the degree of improvement in their quality of life postsurgery by comparing the pre and postoperative validated Tamil/vernacular version of RAND SF-36 scores and Medical Research Council (MRC) dyspnea score. Results  As per preoperative computed tomography (CT), the mean length of stenosis was found to be 1.5 cm while the mean length of trachea resected was 4.75 cm. We achieved a decannulation rate of 61.53%. There was an estimated loss of 3.20 +/- 1.90 cm of normal trachea from the lower border of the stenosis until the lower border of the stoma that was lost during resection. Analysis of SF-36 and MRC dyspnea scores revealed significant improvement in the domains of physical function postoperatively in comparison with the preoperative scores ( p  < 0.05). Conclusion  Diligent placement of tracheostomy in an emergency setting with respect to the stenotic segment plays a pivotal role in minimizing the length of the resected segment of normal trachea.

导言 随着重症监护技术的发展,插管后气管狭窄的发生率也在不断增加。气管切除和吻合术一直是治疗 III 级和 IV 级气管狭窄的金标准。关于手术的决定因素和结果,文献中并没有很好的科学证据。目的 本研究旨在确定气管瘤部位对气管切除吻合术患者手术效果和术后生活质量的影响。方法 对 13 名在 3 年内接受气管切除和吻合术的患者进行为期 3 个月的前瞻性随访,通过比较术前和术后经过验证的泰米尔语/方言版 RAND SF-36 评分和医学研究委员会(MRC)呼吸困难评分,确定患者术后生活质量的改善程度。结果 根据术前计算机断层扫描(CT),发现气管狭窄的平均长度为 1.5 厘米,而切除的气管平均长度为 4.75 厘米。我们的解禁率为 61.53%。从气管狭窄的下缘到造口的下缘,估计切除时损失了 3.20 +/- 1.90 厘米的正常气管。对 SF-36 和 MRC 呼吸困难评分的分析表明,与术前评分相比,术后患者的身体功能明显改善(P 结论 在急诊情况下,针对狭窄段谨慎放置气管造口对于最大限度地减少正常气管被切除段的长度起着至关重要的作用。
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引用次数: 0
Use of K-Y Jelly on Throat Packs for Postoperative Sore Throat after Nasal Surgery: A Randomized Controlled Trial. 使用 K-Y 胶喉咙包治疗鼻腔手术后的喉咙痛:随机对照试验
IF 1.1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-01-04 eCollection Date: 2024-04-01 DOI: 10.1055/s-0043-1776724
Ahmed Mahmoud M M Elgarhy, Saeed Mostafa Abdelhameed, Othman Saadeldien Yahia, Wael Mohamed Elmahdy Ibrahim, Tamer Mohamed Ahmed Ewieda, Mahmoud M Elsayed, Marwa M Abdel-Aziz, Naglaa A Elshehawy, Hussein Magdy Abdelkader, Mahmoud Hamdy Al Boghdady, Ayman Yehia Abbas

Introduction  Postoperative sore throat (POST) is a fairly common side effect of general anesthesia. The K-Y jelly is a well-known lubricant used in many medical procedures. Objective  In this randomized study, we evaluated the use of throat packs soaked with K-Y jelly for POST outcomes in patients submitted to nasal surgery. Methods  The present double-blinded, randomized, controlled study included 140 ASA I-II patients undergoing nasal surgery under general anesthesia. Patients received either or K-Y jelly or water-soaked X-ray detectable throat packs fully inserted into the mouth to occlude the oropharynx. Results  Comparison between the studied groups regarding the severity of POST assessed by visual analog scale revealed significantly lower POST levels in the K-Y jelly group on recovery from anesthesia, and at 2, 4, and 6 hours postoperatively. Conclusions  The use of K-Y jelly-soaked throat packs was associated with less severe POST after nasal surgery.

导言 术后咽喉痛(POST)是全身麻醉的一种相当常见的副作用。K-Y 果冻是一种众所周知的润滑剂,在许多医疗程序中都有使用。在这项随机研究中,我们评估了使用浸有 K-Y 果冻的咽喉包对鼻腔手术患者术后咽喉痛的治疗效果。方法 本项双盲、随机对照研究纳入了 140 名在全身麻醉下接受鼻腔手术的 ASA I-II 级患者。患者接受 K-Y 果冻或用水浸透的 X 射线可探测咽喉包,并将其完全塞入口腔以闭塞口咽部。结果 通过视觉模拟量表评估 POST 的严重程度,比较两组患者的情况发现,K-Y 果冻组患者在麻醉恢复时以及术后 2、4 和 6 小时的 POST 水平明显较低。结论 鼻腔手术后使用 K-Y 胶冻浸泡喉咙包可降低 POST 的严重程度。
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引用次数: 0
Inflammatory Modifications in Paranasal Sinuses and Ostiomeatal Complex Anatomical Variations in Jet Aircraft Pilots: A Computed Tomography Study. 喷气式飞机飞行员副鼻腔鼻窦的炎症性改变和鼻腔鼻窦复合体的解剖变异:计算机断层扫描研究
IF 1.1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-11-29 eCollection Date: 2024-04-01 DOI: 10.1055/s-0043-1773761
Yeda da Silva, Luciana Munhoz, José Rodrigues Parga Filho, Andreza Gomes Damasceno, Cesar Felipe França da Rosa, Eduardo Bilaqui Zukovski, Erik Zhu Teng, Emiko Saito Arita, Cláudio Campi de Castro

Introduction  Jet aircraft pilots are exposed to huge pressure variation during flight, which affect physiological functions as systems, such as the respiratory system. Objectives  The objective of the present investigation was to evaluate inflammatory changes of paranasal sinuses of jet aircraft pilots before and after a jet aircraft training program, using multislice computed tomography (CT), in comparison with a group of nonairborne individuals with the same age, sex, and physical health conditions. A second objective of the present study was to assess the association between the ostiomeatal complex obstruction and its anatomical variations. Methods  The study group consisted of 15 jet aircraft pilots participating in the training program. The control group consisted of 41 nonairborne young adults. The 15 fighter pilots were evaluated before initiating the training program and after their final approval for the presence of inflammatory paranasal sinus disease. The ostiomeatal complex anatomical variations and obstructions were analyzed in pilots after the training program. Results  Jet aircraft pilots presented higher incidence of mucosal thickening in maxillary sinus and anterior ethmoid cells than controls. Prominent ethmoidal bulla showed significant association with obstruction of the osteomeatal complex. Conclusions  Jet aircraft pilots present increased inflammatory disease when compared with nonairborne individuals. The presence of a prominent ethmoidal bulla is associated with ostiomeatal complex obstruction.

引言 喷气式飞机飞行员在飞行过程中会受到巨大压力变化的影响,从而影响呼吸系统等系统的生理功能。本研究的目的是利用多层计算机断层扫描(CT)技术,评估喷气式飞机飞行员在接受喷气式飞机训练前后副鼻窦的炎症变化,并与一组年龄、性别和身体健康状况相同的非飞行员进行比较。本研究的第二个目的是评估输卵管穹隆复合体阻塞与其解剖变异之间的关联。方法 研究组由 15 名参加培训计划的喷气式飞机飞行员组成。对照组由 41 名未参加过飞行训练的年轻人组成。这 15 名战斗机飞行员在参加培训计划之前和最终获得批准之后都接受了鼻旁窦炎症性疾病的评估。在培训计划结束后,对飞行员的鼻腔鼻窦复合体解剖变异和阻塞情况进行了分析。结果 喷气式飞机飞行员上颌窦和乙状窦前细胞粘膜增厚的发生率高于对照组。突出的乙状鼓包与骨膜复合体的阻塞有显著关联。结论 喷气式飞机飞行员与非飞行员相比,炎症性疾病增加。突出的乙状鼓室与骨窗复合体阻塞有关。
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引用次数: 0
Prognostic Value of Polypoid Changes of the Middle Turbinate in Relapsed Nasal Polypi after FESS: A Prospective Cohort Study. 鼻息肉切除术后复发鼻息肉的中鼻甲息肉样变的预后价值:一项前瞻性队列研究
IF 1.1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-11-29 eCollection Date: 2024-04-01 DOI: 10.1055/s-0043-1776730
Alaa Mohamed Abdelsamie, Hossam Mohamed Abdelazeem, Gena Kerollos Dawood, Taha Mohamed Abdelaal

Introduction  Despite the high level of patient satisfaction with functional endoscopic sinus surgery (FESS) and the clinical improvement, polyp recurrence is observed in 23% to 87% of patients and requires reoperation. Objective  To assess the prognostic value of polypoid changes of the middle turbinate (PCMT) in relapse of paranasal sinus polyps in patients with chronic rhinosinusitis with nasal polyp (CRSwNP) after FESS and the effect of partial middle turbinectomy (PMT) on the outcome of surgery. Methods  We conducted a prospective clinical study on 60 patients with CRSwNP with and without PCMT. The patients were allocated into three groups: group I included twenty patients without PCMT; group II, twenty patients with PCMT; and group III included twenty patients with PCMT submitted to PMT. The patients were evaluated endoscopically according to the Lund-Kennedy endoscopic scoring system, radiologically according to the Lund-Mackay scoring system, and symptomatically through the 22-item Sinonasal Outcome Test (SNOT-22). Results  The total postoperative Lund-Kennedy score differed significantly among the 3 groups ( p  < 0.001), with a group II presenting a significantly higher total score compared to groups I and III. The Preoperative SNOT-22 score differed significantly among the three groups ( p  = 0.013), with group II presenting a significantly higher score compared to group I. There was a significant association involving the 3 groups and relapse at 12 months ( p  = 0.029); relapse was higher in group II (50.0%) than in groups I (20%) and III (15.0%). Conclusion  There was a significant association between PCMT and the relapse of nasal polyps. Also, nasal polyposis recurred at a lower rate in the group submitted to middle turbinate resection compared to the group in whom it was preserved.

引言 尽管患者对功能性内窥镜鼻窦手术(FESS)的满意度很高,临床症状也有所改善,但仍有 23% 至 87% 的患者鼻息肉复发,需要再次手术。目的 评估中鼻甲息肉样变(PCMT)在慢性鼻窦炎伴鼻息肉(CRSwNP)患者行 FESS 术后鼻旁窦息肉复发的预后价值,以及中鼻甲部分切除术(PMT)对手术效果的影响。方法 我们对 60 名伴有和未伴有中鼻甲部分切除术的 CRSwNP 患者进行了前瞻性临床研究。患者被分为三组:第一组包括 20 名未进行中涡管部分切除术的患者;第二组包括 20 名进行了中涡管部分切除术的患者;第三组包括 20 名进行了中涡管部分切除术并接受了中涡管部分切除术的患者。根据伦德-肯尼迪内窥镜评分系统对患者进行内窥镜评估,根据伦德-马凯评分系统对患者进行放射学评估,并通过 22 项鼻窦结果测试(SNOT-22)对患者进行症状评估。结果 3组患者的术后Lund-Kennedy总评分差异显著(P = 0.013),其中II组患者的评分明显高于I组。结论 PCMT 与鼻息肉复发之间存在显著关联。此外,与保留中鼻甲的组别相比,接受中鼻甲切除术的组别鼻息肉复发率较低。
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引用次数: 0
Evaluation of Minimum Recording Time and the Influence of Time in the Supine Position on Out-of-Center Sleep Tests. 评估最短记录时间和仰卧位时间对中心外睡眠测试的影响。
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-11-29 eCollection Date: 2024-10-01 DOI: 10.1055/s-0043-1769495
Raquel Chartuni Teixeira, Michel Burihan Cahali

Introduction  The prevalence of moderate to severe sleep-disordered breathing is of 17% among men aged between 50 and 70-years, and of 9% among women in the same age group. In Brazil, obstructive sleep apnea (OSA) is also highly prevalent, and it is associated with metabolic and cardiovascular impacts, excessive daytime sleepiness, and increasing risk of traffic accidents. Laboratory-based polysomnography is the gold standard test for OSA diagnosis. However, its complexity has led to the search for alternatives to simplify the diagnosis, such as the out-of-center sleep test (OCST). Objectives  To discusses the minimum OCST recording time and the potential effects of the supine position on this parameter. Data Synthesis  We conducted a search on the PubMed, Web of Science, Scopus, and Embase databases to identify relevant studies on OCST recording time and a possible association with body position. We used a combination of terms, including Obstructive Sleep Apnea and Home Monitoring OR Home Care Services OR Portable Monitoring AND Supine OR Position OR Recording Time OR Positional Obstructive Sleep Apnea . The references of the selected articles were also reviewed to find other relevant studies. Through our approach, eighteen articles were retrieved and included in the present study. Conclusion  Since OCSTs are conducted in an unattended environment, with potential signal loss during the night, it is crucial to determine the minimum recording time to validate the test and assess how the time spent in the supine position affects this parameter. After reviewing the literature, this topic remains to be clarified, and additional studies should focus on that matter.

导言:在 50 岁至 70 岁的男性中,中度至重度睡眠呼吸障碍的发病率为 17%,在同一年龄段的女性中为 9%。在巴西,阻塞性睡眠呼吸暂停(OSA)的发病率也很高,它与代谢和心血管影响、白天过度嗜睡以及增加交通事故风险有关。基于实验室的多导睡眠图是诊断 OSA 的金标准测试。然而,由于其复杂性,人们开始寻找简化诊断的替代方法,如中心外睡眠测试(OCST)。目的 讨论最短 OCST 记录时间以及仰卧位对该参数的潜在影响。数据综述 我们在 PubMed、Web of Science、Scopus 和 Embase 数据库中进行了搜索,以确定有关 OCST 记录时间以及与体位可能存在的关联的相关研究。我们使用了多个术语组合,包括阻塞性睡眠呼吸暂停和家庭监测或家庭护理服务或便携式监测和仰卧或体位或记录时间或体位性阻塞性睡眠呼吸暂停。我们还查阅了所选文章的参考文献,以查找其他相关研究。通过我们的方法,共检索到 18 篇文章,并将其纳入本研究。结论 由于 OCST 是在无人看管的环境下进行的,夜间可能会出现信号丢失,因此确定最短记录时间以验证测试并评估仰卧位所花费的时间对该参数的影响至关重要。在查阅文献后,这一问题仍有待澄清,更多的研究应关注这一问题。
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引用次数: 0
Hearing Performance in Cochlear Implant Users Who Have Facial Nerve Stimulation 接受面神经刺激的人工耳蜗使用者的听力表现
Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-11-14 DOI: 10.1055/s-0043-1775809
Larissa Veloso Rocha, Maria Valéria Schmidt Goffi-Gomez, Ana Cristina Hoshino, Robinson Koji Tsuji, Ricardo Ferreira Bento
Abstract Introduction Facial nerve stimulation (FNS) is a complication in cochlear implant (CI) when the electrical current escapes from the cochlea to the nearby facial nerve. Different management to reduce its effects are available, although changes might result in a less-than-ideal fitting for the CI user, eventually reducing speech perception. Objective To verify the etiologies that cause FNS, to identify strategies in managing FNS, and to evaluate speech recognition in patients who present FNS. Methods Retrospective study approved by the Ethical Board of the Institution. From the files of a CI group, patients who were identified with FNS either during surgery or at any time postoperatively were selected. Data collection included: CI manufacturer, electrode array type, age at implantation, etiology of hearing loss, FNS identification date, number of electrodes that generated FNS, FNS management actions, and speech recognition in quiet and in noise. Results Data were collected from 7 children and 25 adults. Etiologies that cause FNS were cochlear malformation, head trauma, meningitis, and otosclerosis; the main actions included decrease in the stimulation levels followed by the deactivation of electrodes. Average speech recognition in quiet before FNS was 86% and 80% after in patients who were able to accomplish the test. However, there was great variability, ranging from 0% in quiet to 90% of speech recognition in noise. Conclusion Etiologies that cause FNS are related to cochlear morphology alterations. Facial nerve stimulation can be solved using speech processor programming parameters; however, it is not possible to predict outcomes, since results depend on other variables.
面神经刺激(FNS)是人工耳蜗植入术中的一种并发症,当电流从耳蜗逃逸到附近的面神经时。可以使用不同的管理方法来减少其影响,尽管更改可能会导致CI用户不太理想的拟合,最终降低语音感知。目的探讨FNS的病因,探讨FNS的治疗策略,评价FNS患者的语音识别能力。方法经本院伦理委员会批准的回顾性研究。从CI组的档案中,选择在手术中或术后任何时间被确定为FNS的患者。数据收集包括:CI制造商、电极阵列类型、植入年龄、听力损失病因、FNS识别日期、产生FNS的电极数量、FNS管理措施、安静和噪音下的语音识别。结果儿童7例,成人25例。导致FNS的病因有耳蜗畸形、头部外伤、脑膜炎和耳硬化;主要的作用包括刺激水平的降低,随后是电极的失活。完成FNS测试的患者在安静状态下的平均语音识别率分别为86%和80%。然而,有很大的可变性,从0%的安静到90%的噪音语音识别。结论引起FNS的病因与耳蜗形态改变有关。面部神经的刺激可以用语音处理器编程参数来解决;然而,预测结果是不可能的,因为结果取决于其他变量。
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International Archives of Otorhinolaryngology
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