International Archives of Otorhinolaryngology最新文献

Objective  To assess the readability and quality of various websites providing information on cochlear implantation (CI) in children in Arabic. Methods  The present is a cross-sectional online search. We conducted searches in the Arab language using the three most popular search engines, Yahoo, Google, and Bing, to search the topics of "cochlear implant" and "cochlear implant in children." The information quality was evaluated through the DISCERN tool, while readability was examined using the OSMAN readability tool, which incorporated two readability metrics: the automated readability index (ARI) and the Läsbarhetsindex (LIX, reliability index). Results  In a study of 50 websites, the median Discerning the Quality of Information on Treatment Choices (DISCERN) quality score was 38, with an interquartile range (IQR) of 29 to 46, suggesting poor quality. Out of the 50 websites evaluated, only 10 were deemed to be of good quality. The median readability ARI was 8th grade (IQR: 6-9), which considered above the level of general population. Certain websites were found to be at or below the suggested 6th grade reading proficiency level. The median LIX was of 69 (IQR: 64-71), indicating that the text is very difficult. There was no correlation between readability and the DISCERN score. Conclusions  Our results suggest that many websites offering information on CIs for children in Arabic exhibit varying levels of quality and are composed in language surpassing the general population's reading ability. Developers should focus on improving the readability of their online content to ensure that the average reader can understand and benefit from the information.

Introduction  Nasal fractures are one of the most common diseases in the otorhinolaryngology emergency room that leads to significant complications. However, there is still no suitable method to prevent their occurrence, which may result from insufficient studies on their causes and related factors. Objectives  To describe the demographic features, pattern, time of consultation, and etiological factors of patients with different types of nasal fractures. Methods  We conducted a retrospective study of the records of patients with a diagnosis of nasal fracture treated between 2010 and 2021. The data included demographic characteristics, type of maxillofacial injury and associated lesions, complication rates, treatment modalities, and a description of the surgery. Results  We included 599 patients, mostly male subjects (81.6%) injured in a road accident (55.3%), with a mean age of 31.64 ± 14.65 years, and mean length of hospital stay of 2.27 ± 2.21 days. Most accompanying fractures were maxillary (38.5%), multiple (24.6%), and mandibular (23.1%). The mean length of hospital stay was statistically different according to the cause of the fracture ( p  = 0.036) and the types of treatment performed ( p  = 0.041). Conclusion  In general, trauma patients in the second to fourth decades of life and of the male gender are more prone to nasal fractures. Identifying the factors affecting the incidence of fractures enables the determination of the presentation patterns and the nature of the lesions to be evaluated. In addition, treatment evaluation and an analysis of the complication rate enable a more realistic interpretation of how patients are managed.

Introduction  In May 2020, the World Health Organization declared Brazil a new epicenter of the coronavirus pandemic. Objective  The present study aims to verify if the frequency of nasal bleeding and/or epistaxis in patients of a tertiary hospital was correlated with the pandemic of coronavirus disease 2019 (COVID-19) and with the use of anticoagulants. Methods  The analysis performed was retrospective from the database of the otorhinolaryngology service of a Brazilian tertiary hospital, comparing 2 periods: 1 from March 2020 to July 2021 comprising the peak of pandemic setting, and another from August 2021 to May 2022. We checked data on the average number of cases/month and on the use of anticoagulants. Results  In the period above mentioned, there were 61 cases of COVID-19-related epistaxis (from a total of 180 cases of nasal bleeding and/or epistaxis), with an average of 12 cases/month, demonstrating an increase in the frequency of cases at the institution, when compared to a study involving 343 cases from the same institution over a period of 42 months (October 2015-March 2019), in which the average was 8.1 cases/month. Among the patients with COVID-19 and nasal bleeding, 55 (90.17%) were using some type of anticoagulant at the time of bleeding: 41% were on subcutaneous heparin; 20% were on subcutaneous enoxaparin; 16.66% were receiving intravenous heparin on continuous infusion bomb (CIB); 6.66% were on extracorporeal membrane oxygenation (ECMO) associated with intravenous heparin on CIB; 4.99% were on oral rivaroxaban; and 1.66% are on oral apixaban. Conclusion  Our study's data confirmed the increase in the number of epistaxis cases and the use of anticoagulants in COVID-19 patients.

Introduction: After the pandemic caused by the coronavirus, many patients have presented remaining otorhinolaryngological symptoms, but most of them are unknown to health professionals.

Objectives: To characterize otorhinolaryngological symptoms and sequelae in hospitalized patients for Covid-19.

Methods: We made a recall to patients hospitalized between April 2020 and April 2022 due to Covid-19. Demographic data, initial and remaining symptoms, days of hospitalization, intubation and/or tracheostomy, and vaccination data were collected.

Results: 845 patients were hospitalized, 441 died, 404 patients were contacted by telephone, but only 109 responded to the questionnaire about initial and remaining otorhinolaryngological symptoms after 1.5 to 2 years of illness, 59 men and 50 women, with an average age of 58.61 years (20 to 94). Two study groups were composed: G 1 (n- 44; with remaining symptoms) and G 2 (n- 65; without remaining symptoms). 81% of patients in G1 and 67% of patients in G2 had been hospitalized for up to 20 days. Intubation occurred in 17 patients (G1-7; G2-10). Seven patients underwent tracheostomy. The most prevalent initial and remaining otorhinolaryngological symptoms, respectively, were dyspnea (68.8%; 14.6%), cough (65.1%; 11.92%), nasal obstruction (47.7%; 5.58%), smell dysfunction (44%; 11%), taste dysfunction (42%; 4.58%). Vaccination was reported by 54 patients (G1-21; G2-34).

Conclusions: Otorhinolaryngological symptoms were common in patients hospitalized for Covid-19, especially dyspnea, cough, nasal obstruction, smell, and taste dysfunction. Although there was a favorable long-term evolution, 40% of patients maintained permanent symptoms, such as smell and taste dysfunction and dizziness, unrelated to the vaccine doses.

Introduction  A meta-analysis of published articles is usually done using standard scales and checklists. Several such scales and checklists are reported in the literature. However, there is little information regarding their utility so one can select the most appropriate one, especially in the field of audiology. Objective  The current study aimed to compare a quality analysis carried out using the standard quality assessment criteria (SQAC) for evaluating primary research papers from a variety of fields', and the Modified Downs and Black Checklist (MDBC) for a set of articles in the area of auditory processing deficits (APDs) in older adults. Methods  Two published checklists suitable for the field of audiology (SQAC and MDBC) were compared for a quality analysis of articles on APD in older adults. The two checklists were compared after categorizing their items into five subsections. Two audiologists rated the articles according to both checklists. Results  The interrater reliability was found to be good for both checklists. Significant differences between the checklists were observed for specific subsections. However, there was no significant correlation between the two checklists. Conclusion  It is inferred that the selection of an appropriate quality assessment checklist depends on the objective of the study. If the aim of a quality analysis study is to differentiate articles based on their overall caliber, or primarily based on the subsections, SQAC is recommended. However, if the aim is to distinguish research articles primarily based on the control of variables, or differentiate intervention-based studies, the MDBC is recommended.

Introduction  Antrochoanal polyp, which is a kind of smooth-surfaced single nasal polyp, is commonly present in cases of nasal obstruction. The pathogenesis of polyp formation is still unclear, but allergy is supposed to be a cause. Objectives  To investigate the expression levels of antioxidant enzymes in antrochoanal polyp tissue. Methods  The antrochoanal polyp group was composed of 23 patients who were diagnosed microscopically, and the control group was composed of 38 healthy patients. The sample of the control group was taken from the inferior turbinate mucosa by punch biopsy under general anesthesia, and the antrochoanal polyp sample was collected from sinus surgery. The cytochrome P450 (CYP) and glutathione S-transferase (GST) expressions of the groups were investigated under microscopy and scored by senior pathologists. Results  The antrochoanal polyp group had statistically less expression of CYP family 1 subfamily A member 1 (CYP1A1) than the control group ( p  < 0.05). Moreover, GST Pi 1 (GSTP1), GST Mu 1 (GSTM1), and GST Alpha 1 (GSTA1) expressions were not different between the groups ( p  > 0.05). Conclusion  Allergy and chronic inflammation are postulated reasons for antrochoanal polyp formation, but, according to our results, we could not detect any relation between antrochoanal polyp formation and GST expression in tissue. However, the decreased level of CYP1A1 expression in the antrochoanal polyp group may be related with the pathogenesis of the antrochoanal polyp formation.

Introduction  The classification and management of laryngomalacia are challenging topics that are continuously updated and modified by pediatric airway surgeons. However, a numerical stratification of the patients to decide on the conservative management or intervention has not yet been established. Objective  To provide an easy approach to cases of laryngomalacia by adopting an updated scoring system with a stepwise management algorithm. Methods  We conducted a prospective study that included patients diagnosed with laryngomalacia over three years. The proposed symptom and history score was used to categorize patients into mild, moderate, and severe grades. Then, the examination and investigation scores designed were applied to the selected cases according to the management algorithm. Basic data from the patients and their flow throughout the study were assessed. Results  The study included 112 patients with a mean age of 4.3 ± 2.2 months. In total, 44 (39.3%) cases were considered mild, 48 (42.86%), moderate, and 20 (17.85%), severe. The examination score was used to assess 68 out of 112 patients, including all moderate and severe cases of laryngomalacia. All of the mild cases were followed up, and none required surgery. The investigation score was applied to 55 cases, including all the severe cases, as preoperative evaluation, and 35 out of 48 moderate cases. Conclusion  This newly proposed scoring system with the associated algorithm is an easily applicable way to deal with, classify, and properly manage laryngomalacia cases.

Introduction  The pediatric cochlear implantation (PCI) outcomes, as seen through the parental perspective questionnaire (PPQ), may provide a more comprehensive and accurate view on the functional status of cochlear implant recipients in real-life situations. However, there is no Hindi language version of the PPQ. Therefore, the purpose of the present study was to translate and culturally adapt the original PPQ into Hindi to measure the outcomes in children with CI. Methods  The original PPQ was translated into Hindi through a forward-backward process. The questionnaire was content- and face-validated. The harmonized Hindi questionnaire consisted of 74 items covering two domains: decision-making (26 items) and outcomes (48 items). It was piloted in 139 parents of children with CI, to determine the validity and reliability and to measure the outcome of PCI. Results  The PPQ-Hindi version was easy to understand for parents. They reported that the questionnaire completion time was appropriate. The instrument had a high degree of content- and face-validity, and it matched the original. The overall Cronbach α was 0.89, and the test-retest reliability coefficient was 0.92. Conclusions  The PPQ was successfully translated into Hindi and adapted to this specific culture and population, exhibiting a good validity and reliability to measure outcomes in PCI. Thus, the instrument has the potential to be an effective tool for parents to self-administer and to evaluate the effects of CI in their children.

Introduction  Hearing is a complex process that involves mechanical, chemical, and neurophysiological components. Changes in hearing can be caused by congenital or acquired etiological factors. Chronic kidney disease (CKD) is one of the causes of hearing loss. Objective  To compare auditory findings before and after a single session of hemodialysis in patients with chronic kidney disease. Methods  A clinical cross-sectional research was conducted with a sample of 23 individuals between 24 to 57 years of age with a diagnosis of CKD undergoing hemodialysis. Distortion product otoacoustic emission (DPOAE) and transient otoacoustic emission (TOAE) tests were performed before and after a session of hemodialysis. Results  The DPOAE test revealed that 26% of the participants had failure in both ears prior to dialysis and 30.4% had failure after dialysis. Comparing the DPOAE and TOAE tests before and after hemodialysis, a slight decrease was found in patients with "fail" results from the predialysis test to the postdialysis test, but the difference did not achieve statistical significance. Conclusions  No significant hearing changes assessed through otoacoustic emissions occurred after a single session of hemodialysis in the sample analyzed.