World Journal of OtorhinolaryngologyHead and Neck Surgery最新文献

Objective: The objectives of this study are: (1) to evaluate the prelacrimal recess-pterygoid window approach (PLR-PWA) for treating cerebrospinal fluid leaks and meningoencephaloceles (CSFLME) in the sphenoidal lateral recess (SLR). (2) To investigate the pneumatization of the SLR and its relationship with surrounding structures, including the lateral pterygoid plate and course of the maxillary nerve (V2).

Methods: This study retrospectively reviewed 13 patients (mean age [46.53 ± 8.44] years) with spontaneous CSFLME in the SLR who underwent the PLR-PWA. The primary and secondary outcomes were surgical success rate and complications, respectively. The pneumatization of the SLR was classified according to Rhoton's classification, and its anatomical relationships with surrounding structures were analyzed using CT scans.

Results: The PLR-PWA was utilized in all patients, achieving a 100% surgical success rate at a median follow-up of 26.8 months. There were 6 (6/13, 54.55%) patients who had immediate postoperative hypoesthesia of the upper lip and face. In all cases, the pneumatization of the SLR extended beyond the lateral aspect of the lateral pterygoid plate, with the full lateral type SLR observed. Notably, in 3 out of 13 cases (23.08%), the V2 coursed below and across the SLR.

Conclusion: The PLR-PWA is indicated for patients with a full lateral type or well-pneumatized SLR and offers a direct and minimally invasive surgical route to the SLR. The degree of pneumatization of the SLR, the course of the V2, and its anatomical relationship to the SLR are essential factors to be considered when this approach is adopted.

Chronic rhinosinusitis (CRS), a complex inflammatory disease with heterogeneous pathogenesis, demands evolving evidence-based strategies. Since the 2018 Chinese guidelines and EPOS2020, international advances in CRS immunopathology and biologics have revolutionized therapeutic approaches, particularly through phenotype-endotype classification and targeted therapies. Concurrently, Chinese research has achieved globally competitive milestones, including phenotype-endotype-driven mechanistic studies, biomarker discovery, and high-quality RCTs evaluating biologics, significantly advancing precision management algorithms. This 2024 update rigorously incorporates China-specific evidence from systematic literature reviews and multicenter studies. Key revisions address critical clinical challenges through structured expert consensus. Newly added evidence tiers and clinical decision pathways enhance practicality for diverse healthcare settings. By integrating domestic innovations with global standards, this guideline establishes a pragmatic framework for personalized care while prioritizing real-world applicability, ultimately aiming to standardize CRS management in China's evolving clinical landscape.

Allergic rhinitis (AR) is a chronic inflammatory disease of the nasal mucosa characterized by allergen sensitization and the involvement of multiple inflammatory mediators. Currently, the treatment of AR mainly includes symptomatic relief, anti-inflammatory therapy, and nerve desensitization. However, these treatments have limitations in fully integrating the underlying mechanisms with the clinical manifestations of AR. This review aims to summarize recent research findings on AR phenotypes and endotypes, enhance understanding of endotype-phenotype associations, and outline various treatment options based on phenotypes and endotypes to provide insights for early recognition and personalized clinical management of patients with AR.

Objectives: The purpose of this study is to identify the earliest appearing auditory electrophysiological indicators that change with age progression in young adults with normal hearing, and to analyze the frequency distribution patterns of these markers in the cochlear.

Methods: In this study, 74 participants with normal hearing were divided into four groups: aged 18-25, 26-30, 31-34, and 35-40 years for statistical purposes. Electrocochleography (EcochG), transient evoked otoacoustic emissions (TEOAE), and Hearing in Noise Test (HINT) were used.

Results: Our study found: (1) EcochG action potential (AP) and summating potential (SP) amplitude of the left ear decreased after 25 years except at 6 kHz. (2) The strength of EcochG AP amplitude peaks at 4 kHz. (3) The EcochG SP/AP has no statistically significant difference between different age groups, and there is no characteristic distribution of frequencies. (4) TEOAE amplitude, TEOAE contralateral acoustic stimulation (CS) amplitude has no statistically significant difference between different age groups. The strength of TEOAE amplitude peaks at 1-2 kHz. (5) There are no significant differences in the HINT among the various age groups. (6) The auditory function of the right ear declines more slowly than that of the left ear.

Conclusion: The study's findings reveal several key insights: (1) The EcochG AP amplitude is the most sensitive electrophysiological indicator of cochlear degeneration. (2) Cochlear electrophysiologic testing exhibits distinct frequency distribution characteristics. (3) There is an inconsistent rate of electrophysiological change between the two ears.

Background: Chronic rhinosinusitis (CRS) significantly reduces quality of life (QoL), but data regarding the extent of its impact is sparse. Questionnaire-based assessments of QoL may neglect aspects of complex patient experiences. Recent studies on asthma patients and other chronic conditions have used self-expression through artwork to better depict patients' experiences. This study aims to analyze the experience of living with CRS by exploring common characteristics represented within artworks.

Methods: A prospective qualitative arts-based study was conducted. Adults with CRS were included (n = 16). Disease severity and depression and anxiety were graded using standardized scales. Patient experience was evaluated using drawings and semi-structured interviews. ChatGPT-4, a generative large-language model, was used to interpret interview transcripts according to the Common-Sense Model for Self-Regulation to identify themes.

Results: Analysis of artworks through interviews identified six main themes: "chronicity and adaptation," "impacts," "emotional toll," "healthcare navigation and advocacy," "resilience and personal growth," and "complexity and nuance." These reveal in greater detail a multifaceted and contradicting emotional landscape shaped by chronic illness. For patients who scored high on depression and anxiety scales, the emotional toll and impacts were more prominently depicted in interviews. Compared with similar studies conducted in patients with asthma, these results highlight the more prevalent difficulties of navigating the healthcare system for patients with CRS.

Conclusion: An arts-based methodology enables in-depth exploration of the impact of CRS on QoL, using large language models, a type of artificial intelligence, to identify common themes amongst individual experiences of CRS patients.