OTO Open最新文献

Objective: The development of health applications (apps) includes those for testing hearing, although most of them are available only in English. This study investigates whether poor English language proficiency creates a barrier for Polish users in the accuracy of such an app in measuring self-determined hearing thresholds.

Study design: The study compared hearing thresholds measured by an English-language app and a professionally conducted reference test, with attention to participants' English proficiency and age.

Setting: The English-language app "Hearing test, Audiogram," was used to determine hearing thresholds. A reference test was performed by an audiologist using specialized equipment.

Methods: Participants were 87 nonnative English language speakers aged 16 to 88. They were divided into 3 groups based on their proficiency in English: no knowledge (Group 1), basic (Group 2), and advanced (Group 3). The mean differences between hearing thresholds determined using the app and the reference tests were measured for each group.

Results: The accuracy of the results varied according to the level of English proficiency. A statistically significant difference was found between Group 1 (no knowledge) and Group 3 (advanced), with mean differences of 13.6, 9.3, and 6.7 dB for Groups 1, 2, and 3, respectively, meaning that discrepancies were larger in the less proficient groups. However, when participant age was considered, language proficiency was less important and was no longer a significant factor.

Conclusion: This study revealed that English language proficiency does affect the accuracy of mobile app-based hearing tests, but age of the user is also important.

Objective: Patients undergoing surgery commonly experience anxiety during their procedure which can negatively affect surgical outcomes. Music therapy has emerged as a promising noninvasive approach to reducing anxiety particularly in patients undergoing otolaryngology procedures.The objective of this study is to evaluate the effectiveness of music therapy on anxiety and pain during these procedures.

Data sources: PubMed and Embase.

Review methods: A systematic search was conducted using the PRISMA approach to retrieve articles published between 1980 and March 2024. The search terms were applied to PubMed and Embase databases. The search term yielded a total of 669 articles on PubMed and 1027 articles on Embase, 5 of which met the inclusion criteria.

Results: Five studies consisting of 4 randomized controlled trials and one case-control studies were included in our study, resulting in a total of 381 patients undergoing various otolaryngology procedures. Music therapy was found to reduce preoperative, perioperative, and postoperative anxiety and pain levels compared to control groups. Furthermore, patients who received music therapy experienced improvements in physiological parameters such as heart rate and blood pressure, indicating a positive impact on stress.

Conclusion: Music therapy offers a potentially cost-effective and noninvasive method of reducing anxiety and pain in otolaryngological surgery patients. Our study indicates that music therapy can serve as a valuable addition to traditional pharmacological approaches in managing surgery-related anxiety and pain. However, more research is needed to standardize music therapy protocols and compare its effect in comparison to other nonpharmacologic and pharmacologic modalities to optimize care for patients.

Objective: Our primary objective was to identify and describe trends in head and neck injuries incurred while participating in barbell weightlifting.

Study design: Cross-sectional analysis.

Setting: National database.

Methods: We used data from the National Electronic Injury Surveillance System (NEISS) from 2014 to 2023. Population characteristics of barbell-related injuries (NEISS Code 3265), including age and sex distributions, were recorded. We further analyzed the distribution of injury anatomic locations, injury types, fracture locations, and patient dispositions. To identify statistical significance, nonparametric tests were performed.

Results: Between 2014 and 2023, 3105 cases of barbell-related head and neck injuries were identified, predominantly in males (n = 2227, 71.7%) with a mean age of 27.7 years (SD: 11.9 years). The majority of patients (n = 2193, 74.5%) were treated and released, while 71 patients (2.3%) required hospital admission. The most affected body part was the head (n = 1,368, 44.1%), followed by the neck (n = 993, 32%), the face (n = 614, 19.8%), the mouth (n = 108, 3.5%), and the ear (n = 22, 0.7%). The most common location of injury was a recreational or sports facility (n = 1143; 36.8%), with other significant locations being the home (n = 542; 17.5%), and unspecified locations (n = 1065; 34.3%). Lacerations were the most common injury type (n = 682; 32.4%). Moreover, lacerations were more significantly associated with barbell weightlifting at home (P < .001) than in a recreational or sports facility.

Conclusion: This study demonstrates that a substantial number of barbell-related injuries occur above the shoulder. This knowledge can inform the development of safety measures, including potential reforms in rules, regulations, and protective equipment.

Objective: Nicotine-containing products have historically been tobacco derivatives like cigarettes, cigars, and dip. Recently, tobacco-free nicotine (TFN) products have been marketed as a healthy alternative. TFN pouches are small, discreet, flavored pouches containing nicotine designed to be placed between the gum and lip. This product does not fit a conventional tobacco category, leading to inaccurate reporting. This study aims to investigate discrepancies in physician documentation of TFN pouches.

Methods: A retrospective chart review was conducted on TFN users.

Setting: Single Health Care System.

Methods: Statistical analyses assessed TFN documentation concordance between social history templates and physician notes.

Results: There were 150 patients who used TFN and 841 patients who vaped. Concordance was higher for vape documentation than TFN pouch documentation (55.9%, 470/841 vs 25.3%, 38/150; P < .001). Of those who used TFN, 60% (90/150) were classified as "Smokeless Tobacco Users" in the social history; however, 35 were inaccurately classified as chew, and 17 did not specify TFN use. Only 38 specified TFN use; only 25% (38/150) of records demonstrated concordance.

Conclusion: Only 25% of records were concordant with physician notes, highlighting the need for a designated place for TFN use within social history templates. Nicotine use history is crucial in the setting of microvascular reconstruction and cosmetic surgeries. Thus, accurate reporting is crucial for future research on the long-term effects of TFN. This study's findings underscore a deficit in current social history templates and the need to recognize TFN pouches as distinct entities.

Choanal polyps (CPs) are benign, inflammatory, solitary lesions extending toward the junction between the nasal cavity/paranasal sinus and the nasopharynx through the choana. This study aimed to evaluate the clinical and histological characteristics of CPs in children compared to adult patients. Characteristics of patients (demography, main complaints, side, localization, surgical approach, histological characteristics, accompanying chronic rhinosinusitis [CRS], association with allergic rhinitis [AR] and aspirin sensitivity, postoperative follow-up period, recurrence rates) were retrospectively reviewed. The patients were classified into children (<18 years) and adults (≥18 years). Our results suggest some clinical and histological specificities of CPs in children compared to adults. Epistaxis, oropharyngeal extension, association with AR and ipsilateral CRS, and angiomatous histological subtype of CPs are more frequent in the pediatric population. Also, the level of eosinophil infiltration of polyp tissue and recurrence rates are higher in pediatrics than in adult population.

Objective: To report a case of oral tongue entrapment due to a metal water bottle and review clinical considerations for managing this rare pathology.

Study design: Case report and literature review.

Setting: Tertiary care hospital.

Methods: A 6-year-old female presented with her tongue trapped in a threaded aluminum water bottle. Upon admission, her tongue was edematous and actively bleeding, though she was spontaneously breathing. A systematic review was then performed to document similar case studies found in the literature.

Results: Emergency removal of the foreign body was performed in the operating room using drill cutting burrs and metal shears. The bottle was successfully removed with minimal injury to the oral tongue. The patient required nasal intubation for seven days to allow the tongue edema to subside. Subsequent literature review identified 14 similar cases, with the vast majority occurring with similar brand of aluminum water bottle.

Conclusion: The increasing use of reusable bottles may lead to a higher incidence of tongue entrapment cases. Awareness of this complication and appropriate management strategies are crucial to prevent severe outcomes in pediatric patients.

Primary hyperparathyroidism (PHPT) is an endocrine disorder marked by elevated secretion of parathyroid hormone (PTH), which results in hypercalcemia and may cause complications in the kidneys and bones. Diagnosing this condition involves ruling out secondary causes and understanding the complexities of the laboratory values associated with PHPT. The disease has become more recognizable to clinicians in an earlier phase thanks to updated screening guidelines. At present, patients can be diagnosed with "classic," "normocalcemic," "normohormonal," or "asymptomatic" PHPT. Many patients are diagnosed through incidental findings of elevated calcium levels or PTH levels during routine blood tests rather than through the presentation of classic symptoms. If asked, patients will invariably harbor subtle or subclinical manifestations despite the absence of overt symptoms. There is debate on whether truly asymptomatic hyperparathyroidism exists.¹ We explore the definition and clinical patterns of asymptomatic hyperparathyroidism and propose concise recommendations for recognizing these patients.

Patients who have undergone total laryngectomy (TL) are, in most cases, affected by lung disease due to smoking habits. Therefore, as part of the follow-up protocol for these patients, a spirometry test should be performed to adequately assess lung function. Current spirometers do not allow for spirometry tests in patients who breathe through a tracheostomy, as the patient cannot perform respiratory acts from the spirometer mouthpiece, which is designed to be used by mouth. We have, therefore, designed a device that allows the test to be performed through the tracheostoma. The device is made of biocompatible polymeric material, modeled using a 3-dimensional printer, reusable, and hermetically connected to the spirometer distally and to the tracheostoma proximally. The device was used on 5 patients who underwent TL and was found to be comfortable, safe, and valid for diagnostic purposes.

Objective: Skull base defects can be challenging to reconstruct. The nasoseptal flap (NSF) remains the first-line option for reconstruction. However, it can be inadequate to cover wide defects or compromised by tumor invasion or prior surgery requiring additional reconstructive options. The goal of the study is to describe a novel flap for clival and craniovertebral junction (CVJ) reconstruction.

Study design: Cadaveric study with an illustrative clinical case.

Setting: Cadaver dissection laboratory and tertiary university hospital.

Methods: Endoscopic endonasal dissection was performed in 15 cadavers. A modification of the inferior incision of the NSF was carried out. The inferior incision was performed at a more cranial location, sparing the mucosa of the posterior septum. Two lateral longitudinal incisions were carried out at the pterygo-sphenoidal junction freeing the nasopharyngeal mucosa. A third incision was performed separating the rostral mucosa from the nasal floor. The resulting flap was rotated postero-superiorly covering the clivus and CVJ.

Results: An inferiorly based butterfly-shaped nasopharyngo-septal flap, consisting of nasopharyngeal and posterior septal mucosa and receiving blood supply from the bilateral ascending pharyngeal arteries, was formulated. The lower wings comprised nasopharyngeal mucosa while the upper wings comprised posterior septal mucosa. The mean surface area of the flap was 12.35 ± 0.21 cm² covering the clivus and CVJ in all cadavers.

Conclusion: The nasopharyngo-septal flap is a novel vascularized flap that is well-suited for reconstructing clival and CVJ defects where the NSF is insufficient and can also be used as a salvage flap in cases where the NSF is unobtainable.

Objective: To provide a review of the science and applicability of current multi-cancer early detection (MCED) tests for otolaryngologists.

Data sources: PubMed, clinicaltrials.gov, company websites.

Review methods: Using PRISMA methodology, primary literature regarding MCED tests was queried from April 26 to May 12, 2024 using MCED search terms. Ongoing clinical trials incorporating MCED screens were identified via the National Institutes of Health clinicaltrials.gov website. Company websites for available or upcoming MCED tests were reviewed.

Conclusion: Long-term robust data regarding the performance characteristics, effects on clinical outcomes, and cost-utility of MCED tests for head and neck cancer are currently lacking. Otolaryngologists should be aware of the implications of MCED tests as these assays become more widely used.

Implications for practice: Although not FDA-approved or covered by insurances at the time of writing of this manuscript, MCED testing is rapidly gaining interest, and patients with positive tests are presenting to otolaryngologists for evaluation. While MCED technologies hold great promise for early detection of disease and potential reduction of morbidity and mortality, more study is needed about their utility for head and neck cancer and optimal diagnostic workflows.