Chinese journal of otorhinolaryngology head and neck surgery最新文献

Objective: This study aims to evaluate the nasal structural and electrophysiological features of patients with postoperative olfactory dysfunction following aesthetic rhinoplasty. Methods: We retrospectively analyzed the clinical features of 30 outpatients (females, aged 33±6 years) from Beijing Anzhen Hospital and China-Japan Friendship Hospital between 2014 and 2023, who complained of olfactory dysfunction following aesthetic rhinoplasty. The control group was 30 healthy females aged 32±9 years. Psychophysical olfactory test (Sniffin' Sticks, SS), olfactory and trigeminal event-related potentials (oERPs and tERPs), and acoustic rhinometry were used for evaluating the olfactory function and nasal structure in patients and healthy controls. SPSS 17.0 software was used to compare the difference in olfactory function and nasal structure between the two groups and to analyze the factors related postoperative olfactory dysfunction. Results: There was a significant difference in the scores on psychophysical olfactory test between the patients and controls (10.78±3.90 vs. 33.66±2.42, t=-23.35, P<0.001). ERPs could be evoked in all patients and controls. Patients showed higher amplitudes of N₁ waves in both oERPs and tERPs than controls (P<0.05 for all), but no differences in the latencies of N₁ and P₂ waves or in the amplitudes of P₂ waves were observed between the two groups (P>0.05 for all). There was no difference in nasal structure between the two groups (P>0.05). However, after nasal decongestant, mucosal congestion in the cross-sectional area (CSA) from the nostril to 6 cm level was found more significantly in patients than controls (nasal congestion index 40.00% vs. 1.00%, t=2.09, P=0.047). Better olfactory function was associated with increasing nasal volumes, increasing nasal threshold and anterior nasal turbinate plane CSA(P<0.05 for all). Conclusion: The important factor related to olfactory dysfunction following aesthetic rhinoplasty may be attributed to local mucosal congestion, rather than nasal structural alteration or neurophysiologic deficits in the olfactory pathway.

Objective: The objective of this longitudinal study is to longitudinally monitor the lexical development and language proficiency of Mandarin-speaking children with cochlear implants (CI) over a three-year post-implantation period while also investigating whether early receptive and expressive vocabulary skills can serve as predictors for later language abilities in CI recipients. Methods: In this study, 42 children with CIs were selected as participants, including 19 males and 23 females, and with a mean age at CI activation of 16.6±4.9 months. Receptive and expressive vocabulary skills were assessed using the Infant Checklist of the Early Vocabulary Inventory for Mandarin Chinese (EVI) at one-year post-activation (T1). Additionally, expressive vocabulary sizes were evaluated using the EVI-Toddler Checklist, while syntactic ability was measured by the Grammatical Complexity test of the Mandarin-Chinese Communicative Developmental Inventory for Infants and Toddlers at two years post-activation (T2). The comprehensive language development level of preschool children, including language comprehension, expression, and grammar ability, was examined during the third year post-activation (T3) using the Revised Scale for Assessment of Language Disorders in Preschool Children. Data analysis was conducted using SPSS 22.0. Results: One year after CI activation, children exhibited a mean receptive vocabulary size of 155.7±52.8 and an expressive vocabulary size of 85.1±63.9. T2's expressive vocabulary size was 455.7±167.7, while the Grammatical Complexity score was 36.5±13.0. The original language development score was determined to be 53.6±14.2 at T3. Correlation analysis revealed significant positive associations between T1's receptive and expressive vocabulary with tests conducted at T2 and subsequent language development measured at T3 (P<0.01). Furthermore, there was a significant correlation between expressive vocabulary at T1 and both tests conducted at T2 (P<0.01), but no significant correlation with subsequent language development measured at T3. Regression analysis showed that T1 receptive vocabulary significantly predicted T2 expressive vocabulary and Grammatical Complexity scores and T3 language development scores. Moreover, the syntactic ability assessed during T2 independently predicted subsequent language proficiency measured at T3. Conclusions: Early receptive vocabulary and grammar ability two years post CI activation significantly predict later language proficiency in children with cochlear implants. Thus, during rehabilitation, emphasis should be placed on enhancing vocabulary and grammar comprehension.

Objective: To understand the prevalence of hearing loss among individuals aged 60 and above undergoing physical examinations and to explore the feasibility of using pure tone audiometry (PTA) for hearing screening in the elderly population, as well as to establish screening criteria suitable for our country. Methods: The study was a cross-sectional study, a total of 1 066 elderly individuals (619 males and 447 females; Age range: 60-90 years old, with an average of 66.5 years old) who underwent physical examinations at the Peking Union Medical College Hospital physical examination center from February to December 2023, were screened using PTA and the Chinese version Hearing Handicap Inventory for the Elderly Screening (CHHIE-S). Different screening criteria were applied to calculate the proportion of individuals who did not pass the PTA screening in the elderly population. The consistency between these results and the screening outcomes of the CHHIE-S scale was analyzed to explore reasonable screening standards. We performed statistical analysis using SPSS 27.0. Results: It was found that 18.39% of the elderly population had moderate or severe hearing loss. The positive rate determined by the detection of pure tones at a fixed dB level was significantly higher than that based on the average hearing threshold across 0.5, 1, 2, and 4 kHz frequencies (4-frequency pure-tone average, 4fPTA), and the difference was statistically significant (χ²=136.56,P<0.001). The criterion of 4fPTA>35 dB HL in the better ear showed the highest consistency with the criterion of CHHIE-S>8, with a Kappa value of 0.554 (P<0.001), and this criterion resulted in a positive rate of 15.57% (166/1 066). Conclusions: Conducting hearing screening based on PTA among the elderly population undergoing physical examinations is an effective and feasible approach. Given the subjective perceptions of the elderly population being screened, a 4fPTA greater than 35 dB HL in both ears might be a reasonable criterion.

Objectives: This study aims to investigate the features of retrograde cricopharyngeal dysfunction (RCPD) and to evaluate the effectiveness and safety of Botulinum toxin-A as a treatment for RCPD. Methods: Twenty-two RCPD patients admitted between February 2024 and November 2024 were included through online and offline methods in The Sixth Medical Centre of Chinese PLA General Hospital (15 males, 7 females, age range, 14-34 years; mean age 25.0±5.2 years). The general condition, symptoms, severity scores, and auxiliary examinations were summarized and analyzed. Operative results and postoperative complications of RCPD patients treated with Botulinum toxin-A were analyzed. Results: All patients could not burp since early childhood, followed by gurgling noises, abdominal flatulence, laryngopharyngeal foreign body sensation, and cervical constriction. The most severe symptom was the inability to burp with a mean score of 4.8. Seven patients who received botulinum toxin injections under the supporting laryngoscopes started burping six days post-operation. With a median follow-up of 5 months, all patients achieved the ability to belch. In none of these seven cases, intraoperative complications were noted including hoarseness, choking cough when drinking water, or dyspnea. One patient experienced laryngopharyngeal reflux and six patients had dysphagia, which were relieved at 1 week and 24.8 days postoperatively. Conclusion: RCPD is a disease characterized by the inability to burp, cricopharyngeal muscle injection by Botulinum toxin-A is effective and safe.