Chinese journal of otorhinolaryngology head and neck surgery最新文献

Objective: To investigate the frequency characteristics of utricular damage and pathological ultrastructural features in patients with unilateral Ménière's disease (MD). Methods: This cross-sectional study included 104 patients with unilateral MD admitted to Shandong Provincial ENT Hospital between July 2019 and September 2021. There were 50 males and 54 females, aged 21-72 years (mean 46.4 years). Disease duration ranged from 1 month to 40 years (median duration 4.5 years). All patients underwent pure-tone audiometry and vestibular function tests, including caloric test, video head impulse test (v-HIT), vestibular evoked myogenic potentials (VEMP), and unilateral centrifugation subjective visual vertical (UC-SVV). Utricular maculae from 4 patients who underwent labyrinthectomy for intractable vertigo were observed under light microscopy and transmission electron microscopy (TEM). Type Ⅰ and Type Ⅱ hair cells were counted and compared, and common pathological changes of the utricular macula were observed. SPSS 19.0 software was used for statistical analysis. Results: According to pure-tone average, patients were clinically staged as follows: stage Ⅰ, 26 cases; stage Ⅱ, 26 cases; stage Ⅲ, 39 cases; and stage Ⅳ, 13 cases. The abnormality rates of vestibular function tests were as follows: 63.5% by caloric test (66/104), 32.7% by v-HIT (34/104), 65.4% by cervical VEMP (cVEMP) (68/104), 68.3% by ocular VEMP (oVEMP) (71/104), and 58.7% by UC-SVV (61/104). There was a statistically significant difference in the abnormality rates between the caloric test and v-HIT, which assessed low-frequency and high-frequency semicircular canal function, respectively (χ²=7.775, P=0.005). However, there was no statistically significant difference in the abnormality rates between oVEMP and UC-SVV, which assessed high-frequency and low-frequency utricular function, respectively (χ²=0.495, P=0.482). Pathological examination under light microscopy revealed monolayer degeneration of the sensory epithelium in the utricular macula, with varying degrees of reduction in the number of both Type Ⅰ and Type Ⅱ hair cells and absence of cilia. No significant difference was observed in the quantity between Type Ⅰ and Type Ⅱ hair cells. TEM examination showed numerous vacuoles formed by swollen endoplasmic reticulum in the hair cells, dilated perinuclear cisternae, edema, scattered lipid droplets, and lysosome distribution within the cells. Occasional mitochondrial swelling was also observed. Conclusions: No frequency-specific characteristics were found in the oVEMP and UC-SVV test results of patients with unilateral MD. Damage was commonly observed in both Type Ⅰ and Type Ⅱ hair cells of the utricular macula, with no significant differences noted in cell count or the degree of damage between the two types.

Objective: To investigate the efficacy and safety of non-surgical comprehensive treatment methods for patients with locally advanced oropharyngeal squamous cell carcinoma (OPSCC) and to analyze the impact of HPV (human papilloma virus) status on the patients' prognoses. Methods: A retrospective analysis was conducted on 152 patients with advanced OPSCC treated with non-surgical comprehensive treatment methods at the Department of Otolaryngology Head and Neck Surgery of the PLA General Hospital from October 2010 to October 2024. There were 114 males and 38 females, aged from 38 to 70 years, with a median age of 55.5 years. The treatments included induction chemotherapy (IC)+concurrent chemoradiotherapy (CCRT)±epidermal growth factor receptor (EGFR) molecular targeted therapy, including 126 patients treated with EGFR molecular targeted drugs during CCRT (124 with nimotuzumab+2 with cetuximab) and 32 patients with PD-1 immunotherapy during induction chemotherapy. Helical tomotherapy (HT) and intensity-modulated radiotherapy (IMRT) techniques were used in radiotherapy. The adverse reactions of chemoradiotherapy were assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 5. survival rates were analyzed using the Kaplan-Meier method and Cox regression analysis. Results: The patients were followed up for 3 to 120 months, with an average follow-up time of 34.4 months. All 152 patients completed the planned radiotherapy and chemotherapy cycles. The 2-year and 3-year overall survival (OS) rates for all patients were 86.8% and 74.6%, respectively, and the progression-free survival (PFS) rates were 83.5% and 73.3%, respectively. In the p16+ patients (n=71), the 2-year and 3-year OS rates were 98.9% and 93.2% respectively, and the PFS rates were 97.6% and 91.1% respectively. For p16- patients (n=33), the 2-year and 3-year OS rates were 77.2% and 61.4% respectively, and the PFS rates were 74.6% and 58.5% respectively. The p16+ patients showed the higher OS and PFS than p16- patients (χ² values were 7.27 and 6.64 respectively, and both P values were <0.05). After treatment, 127 cases (83.3%) developed grade 3 oropharyngeal mucositis, and 7 cases (4.6%) required nasogastric feeding or parenteral nutrition. No patients underwent gastrostomy, and all patients were able to tolerate the adverse reactions. Conclusion: Non-surgical comprehensive therapy (IC+CCRT±EGFR inhibitors) is an effective treatment modality for advanced OPSSC, and patients can generally tolerate the associated adverse reactions. Moreover, p16+ patients exhibit a higher survival rate compared to p16- patients.

Objective: This study aims to preliminarily explore the impact of cognitive function on 2-digit and 3-digit digit-in-noise tests in the Ningbo dialect version, particularly when used for hearing screening. Methods: A total of 31 older native speakers of the Ningbo dialect were selected. The cohort comprised 13 males and 18 females, with an age range of 60 to 88 years and a mean age of 73.6 years. Participants completed pure-tone audiometry, the Ningbo dialect versions of the 2-digit and 3-digit digit-in-noise tests twice, the Chinese version of the Montreal Cognitive Assessment (MoCA-BC) basic scale, and the auditory version of the digit span test. Results: Spearman's correlation analysis showed that MoCA-BC scores were significantly correlated only with the second SRT (speech reception threshold) of the digit triplet test. There was no significant correlation between digit span scores and the results of any of the digit-in-noise tests. Attention scores from the MoCA-BC were significantly correlated with the first (rs=-0.374, P=0.038) and second (rs=-0.369, P=0.041) SRTs of the 3-digit condition but showed no significant correlation with the first and second SRTs of the 2-digit condition. The effectiveness of the 3-digit and 2-digit in hearing screening was found to be generally consistent. When using an average hearing threshold of 35 dB HL in the better ear as the hearing screening cut-off point, ROC curve analysis revealed that the areas under the curve (AUC) for the first and second trials of the 2-digit and the first and second trials of the 3-digit test were 0.868, 0.864, 0.873, and 0.857, respectively. Conclusion: Cognitive function has little effect on the results of 2-digit and 3-digit digit-in-noise tests. However, compared to the 3-digit, the 2-digit is simpler and less affected by cognitive decline.

Objective: To investigate the clinical characteristics of patients with oropharyngeal squamous cell carcinoma (OPSCC) and the relationship between the clinical characteristics and pre-treatment inflammatory parameters such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation response index (SII), and systemic inflammation response index (SIRI). Methods: A retrospective analysis was conducted on the clinical data of 149 OPSCC patients treated in two tertiary hospitals, Shanxi Province Cancer Hospital and Shanxi Bethune Hospital, between January 2017 and January 2024, including 129 males and 20 females, aged from 37 to 84 years old. The patients were grouped based on HPV infection status (p16 expression), namely p16-positive group and p16-negative group, and statistical analysis was performed to evaluate the correlation between the inflammatory parameters and clinical factors such as clinical stage, treatment regimen, and prognosis in two groups. Statistical analysis was conducted using SPSS 29.0 software. Results: In this cohort, 56.4%(84/149) of OPSCC patients were p16-positive. The total 1-year and 3-year survival rates were 87.0% and 66.5%, respectively. Analysis showed p16 status was an independent prognostic factor (HR=0.444, 95%CI: 0.206-0.957, P=0.038). No significant difference in prognosis was observed between p16-positive and p16-negative groups when NLR, PLR, and SII levels were elevated (all P>0.05). Pre-treatment SII levels were significantly higher in p16-positive patients compared to p16-negative patients (62.4% vs. 37.6%, χ²=8.021, P=0.005). Elevated pre-treatment PLR levels indicated a higher risk of lymph node metastasis (χ²=4.791, P=0.029). Conclusion: Elevated levels of NLR, PLR, and SII may attenuate the prognostic advantage of HPV-positive OPSCC. SII and PLR may play important roles in predicting HPV infection status and the risk of cervical lymph node metastasis in OPSCC patients.