Laryngo-rhino-otologie最新文献

Background: Chronic rhinosinusitis (CRS) has a negative impact on health-related quality of life (HRQoL). Functional endoscopic sinus surgery (FESS) is the treatment of choice for those not responding to medical treatments. To date, the short-term effects of FESS on HRQoL are still unclear.

Objective: Evaluation of the short-term effects of FESS on HRQoL in CRS patients using the SNOT-22 questionnaire.

Methods: The results of the validated German version of the Sino-Nasal Outcome Test-22 (SNOT-22) questionnaire were analysed from 89 patients with CRS before surgery and 10-14 days (n = 77), four (n = 77), six weeks (n = 76) and 6 months (n = 71) after FESS, and compared with those of 1,000 healthy controls selected using a non-probability quota sample in accordance to the distribution of the German Microcensus.

Results: Compared to the preoperative mean SNOT-22 score (47.35), CRS patients significantly improved in HRQoL 10-14 days (31.75, p < 0.01), 4 weeks (25.84, p < 0.01), 6 weeks (24.16, p < 0.01) and 6 months after FESS (27.16, p < 0.01). Pre- and 6 months postoperatively, the five most important SNOT-22 items were nasal obstruction, smell and taste reduction, thick, mucous nasal secretions, need to blow the nose and postnasal drip. At the 2, 4 and 6-week follow-up, the reduction in smell and taste was most frequently perceived as limiting the HRQoL.

Conclusions: This follow-up study shows for the first time that the reduction in smell and taste should be treated and controlled concervatively in the short term after FESS.

Epistaxis is one of the most common emergencies in otorhinolaryngology. The spectrum ranges from mild, self-limiting cases to life-threatening hemorrhages. Depending on the severity and course of the condition, management can be either outpatient or involve inpatient monitoring, possibly with surgical treatment.A retrospective systematic evaluation was conducted on all outpatient and inpatient patient data diagnosed with epistaxis from January to December 2021. Epistaxis associated with tumors, trauma, and postoperative epistaxis were excluded.A total of 707 patients were included. Seasonally, the highest number of patients presented in January. Outpatient management was possible for 80.8% of the cases, while 19.2% required inpatient admission. Among the inpatients, 15.4% required surgical intervention. Within the entire study cohort, 61.1% of the patients were male. Among the inpatients who underwent surgical treatment, the proportion of male patients was even higher (81.0%). The majority (73.1%) of the inpatients were on at least one anticoagulant medication. Advanced age (p=0.044) and the presence of posterior epistaxis (p<0.001) were significantly associated with the need for inpatient treatment. No children required inpatient care.Epistaxis is a common condition in otorhinolaryngology, predominantly affecting older male patients and those on anticoagulant therapy in severe cases within the studied cohort. Surgical intervention under general anesthesia was infrequently necessary for the treatment of epistaxis in the overall study population (3%).

Objective: Despite cochlear implantation, CI users experience difficulties in challenging listening situations. In German-speaking countries, there are no interventions to promote specific coping strategies for such situations. The present study examines persistent everyday limitations and the relevance of potential intervention content in order to develop a self-help program for CI rehabilitation.

Material and methods: 56 CI users from three German CI centers were recruited and completed an online survey on demographic data, hearing biography, hearing handicap and potentially relevant intervention content. The intervention content presented included the following categories: Medical Aspects, Communication Improvement Aspects, Psychosocial Aspects, Technical Aspects, Specific Aspects.

Results: The hearing handicap was moderate to severe in this sample. The content categories presented for the design of a self-help program were all rated as "important". The duration of CI provision correlated significantly negatively with the assessment of the relevance of psychosocial aspects. Further significant correlations were found between the severity of the hearing handicap and the rating of the relevance of aspects for improving communication, psychosocial and technical aspects.

Conclusion: A self-help program that takes into account the contents examined could provide promising support for the CI rehabilitation process and will be developed and evaluated subsequently.