Journal of Laryngology and Otology最新文献

Objective: To compare characteristics between stroke populations with and without sensorineural hearing loss (SNHL) and assess the impact of SNHL on stroke outcome.

Methods: A retrospective study of patients admitted with stroke was carried out. Patients were divided into two groups, where group A were diagnosed with SNHL and group B were without SNHL. Baseline age, gender, vascular risk factors and disability were compared. Logistic regression analyses were performed with three-month mortality and SNHL as dependent variables.

Results: A total of 631 admissions were reviewed, with mean age 79.2 years, including 305 patients with SNHL and 326 without. More severe disability was more prevalent in patients with SNHL. Sensorineural hearing loss was not associated with increased mortality (odds ratio = 1.1, 95 per cent confidence interval = 0.7-2.0, p = 0.668). Hypertension was present in 210 (68.9 per cent) with SNHL versus 189 (58 per cent) without SNHL (p = 0.005). Small-vessel disease aetiology was more prevalent in SNHL 51 (16.7 per cent) versus 30 (9.2 per cent) without SNHL (p = 0.005).

Conclusion: Sensorineural hearing loss appears to have an association with stroke of small-vessel disease aetiology and hypertension. Sensorineural hearing loss does not affect three-month mortality but is associated with increased disability.

Objectives: This study aimed to explore the influence of laryngopharyngeal reflux on the features of vocal fold polyps and prognosis after office-based transnasal vocal fold polypectomy.

Methods: Eighty-four vocal fold polyp patients were retrospectively analysed. Patients were assigned to laryngopharyngeal reflux or non-laryngopharyngeal reflux groups using pre-operative Reflux Symptom Score-12.

Results: The laryngopharyngeal reflux group had significantly higher pre-operative Reflux Sign Assessment scores, worse lifestyle and worse eating habits than the non-laryngopharyngeal reflux group. After office-based transnasal vocal fold polypectomy, the Reflux Symptom Score-12 and Reflux Sign Assessment score decreased in both groups, although the laryngopharyngeal reflux group still had higher values. The non-laryngopharyngeal reflux group had better vocal fold morphology recovery than the laryngopharyngeal reflux group. Multivariate logistic regression analysis demonstrated that smoking and a higher pre-operative Reflux Symptom Score-12 score were independent risk factors for poor prognosis.

Conclusions: Laryngopharyngeal reflux is detrimental to vocal fold recovery of vocal fold polyp patients following office-based transnasal vocal fold polypectomy. For vocal fold polyp patients with laryngopharyngeal reflux, lifestyle and diet guidance should be focused.

Objective: This study aimed to determine if a history of tinnitus is associated with the risk of developing dementia.

Method: A nationwide population-based case-control study including all eligible adults in Taiwan.

Results: A total of 15 686 patients were included in the study, with 7843 individuals making up each of the case and control groups. Patients with a history of tinnitus were associated with a statistically significant higher risk of being diagnosed with dementia before reaching 65 years old (50 years ≤ age <65 years) (adjusted odds ratio 2.68, 95 per cent confidence interval (CI) 1.19-6.05, p = 0.017). No statistical significance was found among those 65 years and older (adjusted odds ratio 1.17, 95 per cent CI 0.90-1.51, p = 0.235).

Conclusion: A history of tinnitus was associated with a 168 per cent increased risk of being diagnosed with dementia in those aged 50-65 years old. This association was not significant in those older than 65 years.

Background: Temporal bone osteoradionecrosis is a rare but significant complication of radiation for head and neck malignancies. Various management techniques have been described, but no clear protocol exists.

Methods: A retrospective case review of patients with temporal bone osteoradionecrosis managed over 15 years was carried out to highlight multidisciplinary team (MDT) management. The review findings were compared with the published literature and a protocol was derived for the management of future cases.

Results: A total of 20 patients were included. The sites of osteoradionecrosis included the external auditory canal, the middle ear and the lateral skull base, presenting with features including recalcitrant pain, infection, neuropathies and intracranial sepsis. Treatments included hyperbaric oxygen, antibiotics, debridement and, in advanced cases, lateral temporal bone resection with vascularised tissue transfer. Post-operative and long-term outcomes were discussed.

Conclusion: Early temporal bone osteoradionecrosis may be managed conservatively. Refractory osteoradionecrosis can be life-threatening because of intracranial complications and sepsis. Such cases need an MDT approach with radical skull-base surgery for removal of necrotic foci and reconstruction using vascularised tissue transfer.

Objectives: The aim of this study is to identify the prognostic factors that may have an effect on the outcome of post-coronavirus disease 2019 acute invasive fungal sinusitis in order to help optimise diagnosis and management.

Methods: This retrospective study involved 60 patients with post-coronavirus disease 2019 acute invasive fungal sinusitis. We identified and studied several factors that may have an effect on the prognosis. These factors included patient-related factors, disease-related factors, and treatment-related factors.

Results: Comorbidities especially renal impairment, previous intensive care unit admission, skin involvement, and intracranial spread of infection are associated with significantly poorer outcomes. Early aggressive surgical debridement is an independent factor associated with better prognosis.

Conclusion: Identifying prognostic factors may have a role in prevention of invasive fungal sinusitis, predicting prognosis, and tailoring patient-specific treatment protocols.