Chinese journal of otorhinolaryngology head and neck surgery最新文献

Objective: To explore the differences in quality of life among patients with olfaction disorders (OD) due to various etiologies and to identify factors influencing olfactory-related quality of life. Methods: This cross-sectional study enrolled patients with OD who visited the Department of Otolaryngology at Fudan University Eye, Ear, Nose, and Throat Hospital between February and June 2024. Psychophysical olfactory test was performed using the Chinese Smell Identification Test (CSIT), which was based on the Chinese population, with the TDI score used as the total score for threshold (T), discrimination (D), and identification (I) tests. The quality of life related to OD was assessed using a brief version of the Questionnaire of Olfactory Disorders (bQOD), which included QOD-P, QOD-Q, and QOD-VAS. Visual analog scales (VAS) was used to rate the degree of subjective decline in olfaction. Statistical analysis was conducted to assess the impact of etiologies, age, gender, onset time, psychophysical olfactory tests, and subjective assessment on olfactory-related quality of life. Results: A total of 419 patients were enrolled, including 220 males and 199 females, with the age of (39.72±14.31) years (range: 5 to 76 years). Among the 419 patients, 380 completed the bQOD and VAS assessment. The results showed that there were intergroup differences in the QOD-P and QOD-Q scores among patients with OD caused by different etiologies (P values were 0.001 and 0.003, respectively). The QOD-P score was negatively correlated with age (P<0.05), and positively correlated with the TDI score (P<0.01). The QOD-Q score was negatively correlated with disease duration (P<0.05), and positively correlated with the patients' subjective olfactory decline as assessed by the VAS score (P<0.01), and had no significant correlation with psychophysical olfactory tests. Female patients had lower QOD-Q scores than male patients (P<0.05). The QOD-VAS score was positively correlated with the patients' subjective olfactory impairment (P<0.01) and showed no significant correlation with psychophysical olfactory tests. Female patients had worse QOD-VAS scores than male patients (P<0.05). Conclusion: Compared with psychophysical olfactory tests, VAS olfactory scores are more closely related to quality of life. Different etiologies, duration of the disease, and gender also affect olfactory-related quality of life.

Objective: To investigate the changes in the narrow band imaging (NBI) phenotypes of oropharyngeal, hypopharyngeal, and laryngeal squamous cell carcinoma after neoadjuvant immunochemotherapy, and to explore the clinical value of NBI endoscopy in re-evaluation and follow-up of pharyngeal and laryngeal squamous cell carcinoma after neoadjuvant immunochemotherapy. Methods: Twenty-nine patients diagnosed with locally advanced pharyngeal or laryngeal squamous cell carcinoma in the First Affiliated Hospital of Xiamen University from November 2021 to January 2024 and receiving 2 cycles of neoadjuvant immunochemotherapy were selected, including 26 males and 3 females, aged 43-80 years. Regular NBI and white light (WL) endoscopy examinations, as well as imaging examinations such as CT scans, were performed. After the neoadjuvant immunochemotherapy, 36 specimens from suspected lesions of the pharynx or the larynx were obtained through surgical resection. The NBI findings of the pharyngeal or laryngeal lesions and their relationships with corresponding pathological and imaging results were analyzed with kappa test, Pearson correlation analysis, McNemar test, and Wilcoxon Signed Rank Test. Results: After neoadjuvant immunochemotherapy, primary lesions showed pathological complete response (pCR) in 9 cases, partial response (PR) in 19 cases, and progressive disease (PD) in one case. The NBI phenotypes of pharyngeal and laryngeal malignant tumors after treatment showed high consistency (kappa=0.818, P<0.01) and significant correlations (r=0.852, P<0.01) with their pathological results. WL endoscopic examinations showed inconsistency (kappa=0.239, P=0.12) with their pathological results. NBI endoscopy was more effective in identifying benign lesions after treatment than WL endoscopy (P=0.031). In cases of both PR and pCR of the primary lesion, there were significant differences in NBI phenotypes before and after neoadjuvant immunochemotherapy (all P<0.05), with phenotypes transitioning to lower malignancy and benign lesions, respectively. Among 19 cases with PR, 16 showed concentric/eccentric regression, and 3 showed multipoint focal regression. NBI endoscopy was more accurate in diagnosing benign or malignant lesions, pCR or PR after treatment compared to CT (all P<0.05). Conclusions: The present NBI microvascular classification of the pharyngeal and laryngeal lesions is still applicable for the diagnosis and evaluation in pharyngeal and laryngeal squamous cell carcinoma after neoadjuvant immunochemotherapy. The changes in NBI phenotypes and ranges can indicate tumor regression, progression, and recurrence. NBI is more accurate in diagnosing pharyngeal and laryngeal squamous cell carcinoma after neoadjuvant immunochemotherapy compared to WL endoscopy and imaging examinations such as CT.

Objective: To compare the efficacy and safety of postauricular injection (PI) and intratympanic injection (II) of glucocorticoids (GC) in the initial treatment of sudden sensorineural hearing loss (SHL). Methods: Electronic databases retrieval (PubMed, Web of Science, CNKI, VIP, WANFANG) was performed to identify all randomized controlled trials about PI and II of GC in the initial treatment of SHL between 2015 and 2024. Meta-analysis was performed on the studies met the inclusion criteria by RevMan5.4. Results: A total of 971 articles were retrieved, and 23 Chinese articles were included after screening. Meta-analysis found that the total effective rate of PI was significantly higher than that of II (OR=1.37, 95%CI:1.15-1.65, P=0.000 6), with higher recovery of the hearing threshold (SMD=1.24, 95%CI:0.01-2.46, P=0.05) and a lower incidence of adverse reactions and complications (OR=0.20, 95%CI:0.15-0.28, P<0.000 01). Conclusions: Compared with II, PI has a better efficacy and safety. Nonetheless, whatever topical administration of GC that can be regarded as the first choice of initial therapeutic schedules to SHL requires further studied.