Journal of Laryngology and Otology最新文献

Objective: To evaluate the effectiveness and safety of endoscopic interventions for managing paediatric subglottic stenosis.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and the Cochrane Handbook, we systematically searched four databases from inception to August 2024. Studies reporting outcomes of endoscopic management of paediatric subglottic stenosis were included. The primary outcome was procedural success; secondary outcomes were recurrence, decannulation and complications.

Results: Forty-three studies involving 1088 children were included. The pooled success rate of endoscopic treatment was 79.2 per cent. Carbon dioxide and potassium titanyl phosphate laser achieved success rates of 79.9 and 100 per cent, respectively. Balloon dilatation and rigid dilatation had success rates of 79.9 and 82.4 per cent, whereas cold knife alone had a lower rate of 47.2 per cent. The recurrence rate was 36.8 per cent and balloon dilatation showed the highest recurrence at 42.2 per cent. The pooled decannulation rate was 60.4 per cent and complications occurred in 3.0 per cent of cases.

Conclusion: Endoscopic interventions are effective for paediatric subglottic stenosis, but recurrence remains common.

Objectives: To highlight our experience in the management of patients with severe subglottic and/or upper tracheal stenosis associated with neurological co-morbidities. Effective tips and tricks in the surgical technique were emphasised.

Methods: This study included 33 patients with neurological co-morbidities who underwent tracheal and/or cricotracheal resection anastomosis. To decrease the anastomotic tension, suprahyoid release was performed and trachea-hyoid detensioning stitches were placed. Surgiflo® was applied over the anastomosis to enhance healing. Surgical and functional outcomes were evaluated.

Results: The decannulation rate was 90.9 per cent. Regarding the functional outcomes, significant improvement of voice and swallowing was noticed after surgery. None of the patients experienced deterioration in their pre-existing neurological conditions following surgery.

Conclusion: Patients with severe subglottic and/or upper tracheal stenosis associated with neurological co-morbidities are challenging. Certain refinements in the surgical technique such as tailored suprahyoid release, tracheo-hyoid detensioning stitches and the application of Surgiflo are crucial to enhance healing, decrease anastomotic tension and improve outcomes.

Objective: This study describes the management and outcomes of temporal bone fractures resulting from falls.

Methods: We retrospectively reviewed patients with traumatic temporal bone fractures from 2018 through 2022.

Results: We analysed 171 patients with temporal bone fractures, 62 (36.3 per cent) of which occurred secondary to falls. Fall patients were significantly older than non-fall patients (mean age 46 vs. 38 years; p = 0.0079) and had higher Modified Frailty Index-5 scores (0.63 vs. 0.20; p = 0.0003). Fall patients had shorter hospital stays (10.1 vs. 15.8 days; p = 0.015), were more frequently discharged home (66.1 vs. 44.0 per cent; p = 0.007) and were less likely to experience non-resolving facial nerve weakness (6.5 vs. 21.1 per cent; p = 0.030).

Conclusion: Patients with temporal bone fractures from falls are older and frailer than non-fall patients and have unique preventative and rehabilitation needs.

Objectives: This study examined the temporal and seasonal distribution of sudden sensorineural hearing loss admissions and audiogram types from 2015 to 2024 using seasonal-trend decomposition with locally estimated scatterplot smoothing.

Methods: A retrospective analysis included sudden sensorineural hearing loss patients admitted to a tertiary otorhinolaryngology clinic between January 2015 and December 2024. Demographics, admission dates and audiogram types were evaluated.

Results: Among 738 patients (mean age 45.7 ± 15.6 years; 58.4% male), admissions varied significantly across years, months and seasons, peaking from November to March. Winter admissions were highest, while autumn had the lowest. Seasonal-trend decomposition with locally estimated scatterplot smoothing confirmed recurring seasonal patterns. Although audiogram types showed no seasonal or pandemic association, their distribution differed significantly by month.

Conclusion: Sudden sensorineural hearing loss admissions demonstrate clear temporal and seasonal clustering, aligning with influenza-like illness peaks and suggesting a viral contribution. Monthly audiogram variations imply possible environmental influences.

Objectives: This study aimed to systematically review the evidence on functional outcomes following dorsal preservation rhinoplasty, with a focus on nasal obstruction.

Methods: A systematic review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. PubMed, Embase, Scopus and Cochrane databases were searched up to March 2025. Studies reporting nasal airway outcomes following dorsal preservation rhinoplasty using subjective or objective measures were included.

Results: Six studies comprising 662 patients were included. Patient-reported outcomes (Nasal Obstruction Symptom Evaluation, Standardized Cosmesis and Health Nasal Outcomes Survey and Visual Analogue Scale) consistently demonstrated significant post-operative improvement. Objective measures (acoustic rhinometry, rhinomanometry and cone-beam computed tomography) showed maintained or improved airway dimensions. dorsal preservation rhinoplasty was functionally equivalent to traditional structural techniques, with low complication (<5 per cent) and revision rates (<2 per cent).

Conclusion: Dorsal preservation rhinoplasty maintains or improves nasal airway function while preserving structural integrity and reducing the need for grafting. It is a safe and effective alternative to traditional dorsal reduction techniques.

Objective: We aim to investigate nutritional management of chyle leaks by a systematic review of the published literature.

Methods: We searched the following databases (Medline, Embase, Cochrane) for literature incorporating nutritional aspects in chyle leak management. We excluded non-English papers, paediatric studies, conference papers, and studies without nutritional intervention.

Results: Among 260 patients (out of 26,270), 81.5.% (n=212/260) achieved chyle leak resolution with nutritional management, while 18.5% (n=48/260) required surgery. Median resolution duration with nutritional management was 8.7 days (range: 4.3 to 22.2), compared to surgical treatment's median of 32 days (range: 18 to 40).

Conclusion: We recommend use of nutritional management in all patients with chyle leaks. There is no evidence supporting one diet over the other however clinically we suggest starting with medium-chain triglyceride/non-/low-fat diets and moving onto total parenteral nutrition, unless medically indicated otherwise.