Laryngo-rhino-otologie最新文献

Background:  The number of oropharyngeal squamous cell carcinomas (OPSCC) caused by human papillomavirus (HPV) has increased significantly in recent years. However, no robust data exist on the incidence of HPV-associated OPSCC as well as their treatment in central Europe.

Aim of the work:  The aim is to establish an epidemiological register of patients with OPSCC in central Europe.

Material and methods:  To close the evidence gap on p16-positive OPSCC, a prospective multicenter registry on incidence, risk factors and treatment of OPSCC in certified Head and Neck Tumor Centers according to the German Cancer Society was established. Data collection was pseudonymously performed using the web-based Research Electronic Data Capture (REDCap).

Results:  In 2022 and 2023, 1312 patients with OPSCC from 34 centers were included. 720 patients (58.2 %) were p16-positive. The most common locations of p16-positive primary tumors were the tonsil (49.9 %) and the base of the tongue (28.7 %). 63.1 % of p16-positive OPSCC received primary surgical treatment, whereas only 48.0 % of p16-negative tumors received primary surgery. Differences are also evident in the adjuvant therapy: 58 % of p16-negative OPSCC did not receive adjuvant therapy after surgery, compared with 37.1 % of p16-positive OPSCC.

Conclusion:  The start of the OPSCC registry study was technically smooth. This registry provides an insight into the current care situation of OPSCC in German-speaking countries and will gain importance through the participation of more centers.

The indications for cochlear implants in children were gradually expended during the last 30 years. This concerns both the age at implantation and the audiological criteria, unilateral or bilateral treatment, the treatment of unilateral deafness and of children with multiple disabilities. Due to the improvement in hearing preservation and new technical developments, it is to be expected that the indication limits will continue to shift in the coming decades.

Background: Many patients who consult the ENT doctor suffer from globus sensation, as a term for a multifactorial symptom description. It is particularly important during initial consultation to take the often-sensitive patients seriously and to offer a structured diagnostic clarification. Today, there is a lack of a screening tool in everyday clinical practice that can be used to differentiate the globus sensations more closely and assess their severity OBJECTIVES: The reliability and validity of the German version of the Glasgow Edinburgh Throat Scale (GETS) were examined.

Materials und methods: The original GETS questionnaire was translated into German (GETS-G) and completed by 60 patients with globus sensation (>3 months) in a prospective observational study. All patients received a clinical examination a sonography of the neck. In patients without an identifiable organic cause, a pH monitoring was carried out.

Results: A local organic cause for the globus sensation was found in 30 patients (50%). In addition, reflux was detected in 24 patients (40%) using pH monitoring. No cause could be determined in only 6 patients (10%). According to the overall score (Q1-Q12), there was no significant difference between these three groups. The Cronbach's alpha for assessing reliability was 0.88 in the 12-item analysis. Principal component analysis yielded a globus scale, dysphagia scale and a chronic pharyngeal irritation scale.

Conclusions: The GETS-G showed high reliability and validity, which justifies its use in patients with globus sensation in German-speaking countries and may lead to a better assessment of the severity of this symptom.

Background: The growing prominence of Artificial Intelligence (AI) in medicine introduces both transformative possibilities and potential challenges. Our study focuses on the current status and perceptions of AI in Head and Neck Surgery (HNS), examining its utilization, benefits, ethical concerns, and protective measures.

Objectives: The study aims to illuminate the existing landscape of AI in HNS in Germany.

Materials and methods: Conducted through a questionnaire, key aspects include its current usage, potential applications (e.g., diagnosis, surgical planning), anticipated benefits (e.g., improved patient care ), and significant ethical concerns (e.g., miscalculations by AI, data privacy).

Results: The survey reveals limited AI adoption in HNS, with substantial potential for improvement. Ethical considerations, especially miscalculations by AI and data privacy, emerge as central issues. The survey emphasizes the crucial role of physician control and the need for legal oversight to address concerns related to AI integration. While AI's presence in HNS is modest, the study identifies opportunities for enhancement. Ethical guidelines and practitioner-centric control are vital for discussions surrounding AI integration.

Conclusions: This research underscores the significance of ethical considerations and practitioner control in the context of AI in surgical practices. It highlights the demand for targeted training to empower practitioners in navigating the complexities of AI technologies in healthcare, ensuring responsible and patient-centric implementation.

Objective: High success rates (SR) for surgical septal perforation repair (SPR) of over 90 % are reported in the literature. We think that realistic SR are significantly lower and wanted to confirm this thesis with the help of a survey among ear, nose, throat ENT specialists from Germany. Surgical trends were also queried.

Material and methods: An anonymous online survey among ENT specialists in Germany was conducted. 356 doctors participated. The collected SR were statistically evaluated, and the operative trends were analysed. It applies a significance level α = 0.05. The SR were collected for 3 different size categories (<1 cm, 1-2 cm, >2 cm).

Results: The SR for SPR <1 cm (median 79 %) was higher than that for 1-2 cm (60 %) and >2 cm (40 %). Surgeons estimated SR significantly higher (90 %, 75 %, 50 %; p-value <0.001 each) than non-surgeons (80 %, 50 %, 25 %). Hospital-based physicians (90 %, 70 %, 50 %) reported significantly higher SR than ambulatory physicians (80 %, 50 %, 30 %, p-value <0.001 each). No linear relationship was found between the total number of SPR performed and SR (r <1cm = 0.16, r1-2cm = 0.18, r >2cm = 0.19). Most SPR were performed with the bridge flap technique (73 %), a closed surgical approach (85 %), an interposition graft (74 %) and postoperative splinting (94 %).

Conclusions: The subjective SR suggest that the SR of SPR is lower than described in the literature. This may be due to short follow-up times, small patient populations and a retrospective design of existing studies. The variety of surgical possibilities confirms the complexity of SPR. Optimising the design of future studies could help to collect realistic SR.