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Angiotensin-Converting Enzyme Insertion/Deletion Gene Polymorphism in Chronic Rhinosinusitis with Nasal Polyps. 慢性鼻窦炎伴鼻息肉患者血管紧张素转换酶插入/缺失基因多态性研究
IF 0.7 Q4 OTORHINOLARYNGOLOGY Pub Date : 2025-01-10 DOI: 10.4274/tao.2024.2024-4-4
Mehmet Emre Sivrice, Vural Akın, Hasan Yasan, Kuyaş Hekimler Öztürk, Yusuf Çağdaş Kumbul

Objective: Inflammatory processes play a role in the etiopathogenesis of chronic rhinosinusitis. Many gene polymorphisms have been associated with inflammation. In this study, we aimed to examine the relationship between angiotensin-converting enzyme insertion/deletion gene polymorphism and chronic rhinosinusitis.

Methods: Fifty-two cases with nasal polyps and 139 control patients were included in the study. Angiotensin-converting enzyme insertion/deletion gene polymorphisms, genotype, and allele distributions were determined. Results were statistically compared between groups.

Results: Statistically significant differences were found between the chronic rhinosinusitis with nasal polyps group and the control group in terms of genotype and allele distribution (p=0.015, 0.003, respectively). There were no significant differences in genotype distribution in the chronic rhinosinusitis with nasal polyps group in terms of non-steroidal anti-inflammatory drug (NSAID) allergy, asthma, and NSAID-exacerbated respiratory disease (p=0.645, 0.660, 0.095, respectively).

Conclusion: We observed that the risk of chronic rhinosinusitis is higher in individuals with the deletion-deletion genotype and D allele of the angiotensin-converting enzyme insertion/deletion gene polymorphism. We believe that these results could be related to the high angiotensin-converting enzyme levels in these patients.

目的:炎症过程在慢性鼻窦炎的发病机制中发挥作用。许多基因多态性与炎症有关。在这项研究中,我们旨在研究血管紧张素转换酶插入/缺失基因多态性与慢性鼻窦炎的关系。方法:选取52例鼻息肉患者和139例对照患者作为研究对象。测定血管紧张素转换酶插入/缺失基因多态性、基因型和等位基因分布。结果组间比较有统计学意义。结果:慢性鼻窦炎伴鼻息肉组与对照组在基因型和等位基因分布上差异有统计学意义(p=0.015, 0.003)。慢性鼻窦炎伴鼻息肉组在非甾体抗炎药(NSAID)过敏、哮喘、非甾体抗炎药加重呼吸系统疾病的基因型分布差异无统计学意义(p分别为0.645、0.660、0.095)。结论:我们观察到血管紧张素转换酶插入/缺失基因多态性的缺失-缺失基因型和D等位基因的个体患慢性鼻窦炎的风险更高。我们认为这些结果可能与这些患者的高血管紧张素转换酶水平有关。
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引用次数: 0
An Unusual Acute Otitis Media Complication: Luc's Abscess. 一种罕见的急性中耳炎并发症:吕氏脓肿。
IF 0.7 Q4 OTORHINOLARYNGOLOGY Pub Date : 2025-01-10 DOI: 10.4274/tao.2024.2024-2-4
Meltem Akpınar, Beyza Demirci

Otitis media, a common childhood disease, can lead to serious complications such as acute mastoiditis and, rarely, Luc's abscess, with life-threatening consequences. Luc's abscess, a rare but severe complication, can occur without acute mastoiditis. This case report details a case of Luc's abscess in a 14-year-old girl with acute otitis media, presenting with ear pain, facial swelling, and hearing loss. Treatment involves a multidisciplinary approach, considering factors like age and abscess extent. Though there is no established standard treatment, this case emphasizes the need for prompt recognition and appropriate intervention to prevent severe complications. This case report emphasizes the importance of tailored, timely interventions for optimal outcomes in affected children.

中耳炎是一种常见的儿童疾病,可导致严重的并发症,如急性乳腺炎和罕见的Luc脓肿,具有危及生命的后果。吕氏脓肿是一种罕见但严重的并发症,可以在没有急性乳突炎的情况下发生。本病例报告详细介绍了一例14岁女孩急性中耳炎的Luc脓肿,表现为耳痛、面部肿胀和听力丧失。治疗涉及多学科方法,考虑年龄和脓肿程度等因素。虽然没有确定的标准治疗方法,但该病例强调了及时识别和适当干预以防止严重并发症的必要性。本病例报告强调了为使受影响儿童获得最佳结果而及时采取有针对性的干预措施的重要性。
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引用次数: 0
Endoscopic Sphenopalatine Artery Cauterization Under Local Anesthesia for Posterior Epistaxis: A Prospective Cohort Study of its Tolerability and Efficacy. 内镜下局麻蝶腭动脉烧灼治疗后鼻出血:一项耐受性和疗效的前瞻性队列研究。
IF 0.7 Q4 OTORHINOLARYNGOLOGY Pub Date : 2025-01-10 DOI: 10.4274/tao.2024.2024-5-2
Urmila Gurung, Narmaya Thapa, Sajish Khadgi

Objective: To assess the tolerability and efficacy of endoscopic sphenopalatine artery cauterization (ESPAC) under local anesthesia (LA) in managing posterior epistaxis.

Methods: It was a prospective, cohort study, conducted in the Otorhinolaryngology Department of a tertiary-level hospital. Patients aged 18 years or above with posterior epistaxis who underwent ESPAC under LA were included. The tolerability of the procedure was reflected by the intraoperative pain measured using an 11-point numerical rating scale while the rebleed rate up to three months postoperatively denoted its efficacy.

Results: A total of 35 patients, 23 males and 12 females, aged 31 to 86 years (mean 57.42 ± 12.94) were included. Five out of 35 (14.2%) patients needed additional procedures besides ESPAC; 82.8% (29/35) had pterygopalatine fossa (PPF) block before ESPAC. The numerical rating scale reflecting the intraoperative pain ranged from 1 to 7 with a mean of 3.6 (± 1.7). The mean score was slightly higher in females than in males. Similarly, those who did not receive PPF block had a higher mean score than those who received it; however, the differences were not statistically significant. Meanwhile, the mean score was the same (3.6) irrespective of any additional procedure besides ESPAC. Amongst the 30 patients who completed the three-month follow-up, two patients rebled, so the overall success rate amounted to 93.3% in three months.

Conclusion: Based on the outcome of this study, ESPAC under LA for posterior epistaxis is well tolerated and is as efficacious as under general anesthesia.

目的:评价局麻下内镜蝶腭动脉烧灼术(ESPAC)治疗后路鼻出血的耐受性和疗效。方法:在某三级医院耳鼻咽喉科进行前瞻性队列研究。年龄在18岁或以上的后鼻出血患者在LA下接受了ESPAC。手术的耐受性反映在术中疼痛的测量中,使用11分的数值评定量表,而术后三个月的再出血率表示其疗效。结果:共纳入35例患者,男23例,女12例,年龄31 ~ 86岁(平均57.42±12.94)。35例患者中有5例(14.2%)需要除ESPAC外的其他手术;82.8%(29/35)患者在ESPAC前有翼腭窝(PPF)阻滞。反映术中疼痛的数值评定量表范围为1 ~ 7,平均3.6(±1.7)。女性的平均得分略高于男性。同样,未接受PPF阻滞的患者的平均得分高于接受PPF阻滞的患者;然而,差异没有统计学意义。与此同时,除ESPAC外,无论进行任何其他手术,平均得分均相同(3.6)。30例患者完成3个月随访,2例复发,3个月总成功率为93.3%。结论:基于本研究的结果,LA下ESPAC治疗后鼻出血耐受性良好,与全麻下一样有效。
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引用次数: 0
Long-term Prospective Comparative Analysis of Ototoxic and Survival Outcomes of Sequential Boost and Simultaneous Integrated Boost of Volumetric Modulated Arc Therapy for Head-Neck Carcinomas. 容量调节弧线治疗头颈癌序贯增强和同步综合增强的耳毒性和生存结果的长期前瞻性比较分析。
IF 0.7 Q4 OTORHINOLARYNGOLOGY Pub Date : 2025-01-10 DOI: 10.4274/tao.2024.2023-10-10
Nidhin Das, Sri Harsha Kombathula, Vidhu Sharma, Puneet Pareek, Kapil Soni, Amit Goyal

Objective: To compare the ototoxicity and survival in head and neck carcinoma patients treated with sequential (SEQ) and simultaneous integrated boost (SIB) of volumetric modulated arc therapy (VMAT).

Methods: This long-term prospective study enrolled patients with histologically confirmed head and neck carcinoma, all receiving VMAT treatment. Audiological assessments were done using various tests at baseline, two weeks, treatment completion, six months, and 12 months. The changes in bone conduction pure tone thresholds were correlated with cochlear dose, comparing SEQ and SIB plans. We also investigated other significant late toxicities that led to dysphagia, voice changes, and xerostomia. Survival was assessed with the Kaplan-Meier analysis.

Results: The study included 93 patients (186 ears), 40 receiving radiation alone and 53 undergoing chemoradiation. Baseline hearing levels for the right and left ears were 13.3±2.3 dB and 14.2±1.5 dB. After 12 months of radiation, levels were 18.5±2.4 dB and 19.11±1.9 dB, respectively. No significant changes were observed between SEQ and SIB plans, but high-frequency shifts occurred. The cochlea tolerated up to 28 Gy without hearing loss in the radiation-alone group but showed loss at 9 Gy when combined with cisplatin chemotherapy. The maximum dose (Dmax) and the mean dose (Dmean) of pharyngeal constrictor muscles predicted dysphagia. No significant SEQ vs. SIB differences were found in late toxicity or survival outcomes.

Conclusion: Modern radiotherapy techniques like VMAT adhere to cochlear dose limits. No significant differences were found between SEQ and SIB plans in sensorineural hearing loss, late toxicity, or survival, making both suitable for head and neck carcinoma treatment.

目的:比较容量调节弧线治疗(VMAT)序贯(SEQ)和同步综合增强(SIB)对头颈部肿瘤患者耳毒性和生存率的影响。方法:这项长期前瞻性研究纳入了组织学证实的头颈部癌患者,所有患者均接受VMAT治疗。听力学评估在基线、两周、治疗完成、6个月和12个月时使用各种测试进行。骨传导纯音阈值的变化与耳蜗剂量相关,比较SEQ和SIB方案。我们还研究了导致吞咽困难、声音改变和口干的其他显著的晚期毒性。用Kaplan-Meier分析评估生存率。结果:本研究共纳入93例(186耳),其中单纯放疗40例,放化疗53例。右耳和左耳基线听力水平分别为13.3±2.3 dB和14.2±1.5 dB。经过12个月的放射治疗后,其水平分别为18.5±2.4 dB和19.11±1.9 dB。SEQ和SIB计划之间没有明显变化,但发生了高频变化。在单独放疗组中,耳蜗耐受高达28 Gy而无听力损失,但在联合顺铂化疗组中,耳蜗在9 Gy时出现听力损失。咽部收缩肌的最大剂量(Dmax)和平均剂量(Dmean)预测吞咽困难。在晚期毒性或生存结果方面,SEQ和SIB没有显著差异。结论:现代放射治疗技术如VMAT符合耳蜗剂量限制。SEQ和SIB方案在感音神经性听力损失、晚期毒性或生存率方面均无显著差异,适用于头颈部癌的治疗。
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引用次数: 0
Risk Factors of Post-Tonsillectomy Bleeding and Differences Between Children and Adults: Implications for Risk Assessment. 儿童和成人扁桃体切除术后出血的危险因素及其差异:风险评估的意义。
IF 0.7 Q4 OTORHINOLARYNGOLOGY Pub Date : 2025-01-10 DOI: 10.4274/tao.2024.2023-10-2
Bülent Öcal, Mehmet Murat Günay, Kemal Keseroğlu, Murad Mutlu, İlker Akyıldız, Cem Saka, Emel Çadallı Tatar, Mehmet Hakan Korkmaz

Objective: To investigate the association between clinical factors and post-tonsillectomy hemorrhage (PTH) including rebleeding episodes.

Methods: The medical records of 1,082 patients who underwent tonsillectomy between May 2018 and April 2019 were reviewed. The entire study cohort included 431 (39.7%) children aged less than six years and 292 (26.9%) adults older than 15 years. Data on patient demographics, surgical indication, dissection technique, tonsils' grade, postoperative analgesia, surgeon's experience, the season of surgery, management of hemorrhage, length of hospital stay, and rebleeding episode were noted.

Results: Postoperative hemorrhage occurred in 87 cases (8.0%) including 32 children (4.0% of children) and 55 adults (18.8% of adults). Age, surgical indication, tonsils' grade, and postoperative use of non-steroidal anti-inflammatory drugs (NSAIDs) were risk factors found to be statistically significant for PTH in univariate analysis (p<0.05). Multivariable analyses identified patients older than 15 years and those who received postoperative NSAIDs to be risk factors of PTH [Odds ratio (OR): 15.5, 95% confidence interval (CI): 7.68-31.27, p<0.001, OR: 0.22, 95% CI: 0.11-0.44, p<0.001, respectively]. About one out of every 60 (1.5%) children had severe oropharyngeal bleeding, whereas every 12th (8.2%) patient of those aged >15 years had severe hemorrhages that warranted surgical hemostasis in the operating room (p<0.001).

Conclusion: The risk of bleeding after tonsillectomy was significantly higher in adults and users of NSAIDs postoperatively. Also, the evidence of minor bleeding increased the risk of a second bleeding episode in adulthood.

目的:探讨扁桃体切除术后出血(PTH)及再出血发作与临床因素的关系。方法:回顾2018年5月至2019年4月1082例扁桃体切除术患者的病历。整个研究队列包括431名(39.7%)6岁以下的儿童和292名(26.9%)15岁以上的成年人。记录了患者人口统计学、手术指征、解剖技术、扁桃体分级、术后镇痛、外科医生经验、手术季节、出血处理、住院时间和再出血事件等数据。结果:术后出血87例(8.0%),其中儿童32例(4.0%),成人55例(18.8%)。单因素分析显示,年龄、手术适应证、扁桃体分级和术后使用非甾体抗炎药(NSAIDs)是PTH的危险因素,有统计学意义(PTH(8.2%))(年龄在bb0 ~ 15岁的患者有严重出血,需要在手术室进行手术止血)(结论:扁桃体切除术后出血的风险在成人和术后使用NSAIDs的患者中明显更高)。此外,有证据表明,轻度出血会增加成年后再次出血的风险。
{"title":"Risk Factors of Post-Tonsillectomy Bleeding and Differences Between Children and Adults: Implications for Risk Assessment.","authors":"Bülent Öcal, Mehmet Murat Günay, Kemal Keseroğlu, Murad Mutlu, İlker Akyıldız, Cem Saka, Emel Çadallı Tatar, Mehmet Hakan Korkmaz","doi":"10.4274/tao.2024.2023-10-2","DOIUrl":"10.4274/tao.2024.2023-10-2","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between clinical factors and post-tonsillectomy hemorrhage (PTH) including rebleeding episodes.</p><p><strong>Methods: </strong>The medical records of 1,082 patients who underwent tonsillectomy between May 2018 and April 2019 were reviewed. The entire study cohort included 431 (39.7%) children aged less than six years and 292 (26.9%) adults older than 15 years. Data on patient demographics, surgical indication, dissection technique, tonsils' grade, postoperative analgesia, surgeon's experience, the season of surgery, management of hemorrhage, length of hospital stay, and rebleeding episode were noted.</p><p><strong>Results: </strong>Postoperative hemorrhage occurred in 87 cases (8.0%) including 32 children (4.0% of children) and 55 adults (18.8% of adults). Age, surgical indication, tonsils' grade, and postoperative use of non-steroidal anti-inflammatory drugs (NSAIDs) were risk factors found to be statistically significant for PTH in univariate analysis (p<0.05). Multivariable analyses identified patients older than 15 years and those who received postoperative NSAIDs to be risk factors of PTH [Odds ratio (OR): 15.5, 95% confidence interval (CI): 7.68-31.27, p<0.001, OR: 0.22, 95% CI: 0.11-0.44, p<0.001, respectively]. About one out of every 60 (1.5%) children had severe oropharyngeal bleeding, whereas every 12<sup>th</sup> (8.2%) patient of those aged >15 years had severe hemorrhages that warranted surgical hemostasis in the operating room (p<0.001).</p><p><strong>Conclusion: </strong>The risk of bleeding after tonsillectomy was significantly higher in adults and users of NSAIDs postoperatively. Also, the evidence of minor bleeding increased the risk of a second bleeding episode in adulthood.</p>","PeriodicalId":44240,"journal":{"name":"Turkish Archives of Otorhinolaryngology","volume":"62 3","pages":"81-87"},"PeriodicalIF":0.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative Analysis of Preoperative Sedation Modalities: Oral Midazolam and Ketamine Versus Chloral Hydrate and Meperidine in Pediatric Tonsillectomy - A Randomized Clinical Trial. 一项随机临床试验:小儿扁桃体切除术中口服咪达唑仑和氯胺酮与水合氯醛和哌嗪术前镇静方式的比较分析。
IF 0.7 Q4 OTORHINOLARYNGOLOGY Pub Date : 2025-01-10 DOI: 10.4274/tao.2024.2023-12-14
Nima Naderi, Soodabeh Emami, Mahsa Banifatemi, Maryam Ghadimi, Ensieh Shahriari, Mohammad Ali Sahmeddini

Objective: A pre-anesthetic medication that is ideal for pediatric patients undergoing tonsillectomy should alleviate pediatric anxiety, facilitate the smooth induction of anesthesia, and have an analgesic effect for postoperative care. This study compared the effectiveness of an oral combination of midazolam and ketamine (MK) with an oral combination of chloral hydrate and meperidine (CM) as premedication in pediatric patients undergoing tonsillectomy.

Methods: This double-blind clinical trial study was conducted with 68 pediatric patients scheduled to undergo tonsillectomy. The participants were randomly allocated into two groups: the CM group, which received oral premedication of 50 mg/kg chloral hydrate and 1.5 mg/kg meperidine, and the MK mixture group, which received oral premedication of 0.5 mg/kg midazolam and 5 mg/kg ketamine. Various parameters such as separation anxiety, agitation during emergence from anesthesia, postoperative pain, postoperative nausea, and vomiting, as well as respiratory depression within a 6-hour period following anesthesia, were carefully recorded and observed.

Results: There were no differences between the two groups in terms of separation anxiety (p>0.05) and post-surgery pain scores (p=0.12). Regarding postoperative agitation, there were significantly more patients in an awake but calm state in the CM group than in the MK (44% vs. 17.64%, p=0.01). The incidence of nausea and vomiting was lower in the CM than in the MK group (47% vs. 76.5%, p=0.02).

Conclusion: This study shows that an oral mixture of CM is more suitable as pre-anesthetic medication in pediatric patients undergoing tonsillectomy than a MK.

目的:一种理想的小儿扁桃体切除术患者的麻醉前用药应能减轻小儿焦虑,促进顺利诱导麻醉,并对术后护理有镇痛作用。本研究比较了口服咪达唑仑和氯胺酮(MK)与口服水合氯醛和哌哌啶(CM)联合作为扁桃体切除术儿童患者术前用药的有效性。方法:对68例拟行扁桃体切除术的儿童患者进行双盲临床研究。随机分为两组:CM组口服水合氯醛50 mg/kg、甲哌啶1.5 mg/kg; MK混合组口服咪达唑仑0.5 mg/kg、氯胺酮5 mg/kg。仔细记录和观察各种参数,如分离焦虑、麻醉苏醒时的躁动、术后疼痛、术后恶心和呕吐,以及麻醉后6小时内的呼吸抑制。结果:两组患者分离焦虑评分(p < 0.05)、术后疼痛评分(p < 0.12)差异无统计学意义。术后躁动方面,CM组清醒平静状态患者明显多于MK组(44% vs. 17.64%, p=0.01)。CM组恶心呕吐发生率低于MK组(47% vs. 76.5%, p=0.02)。结论:本研究表明,口服混合CM比MK更适合作为小儿扁桃体切除术患者的麻醉前用药。
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引用次数: 0
Management of Disseminated Rhinosporidiosis: Experience From a Single Tertiary Institution. 散发型鼻孢子虫病的治疗:一家高等院校的经验。
IF 0.7 Q4 OTORHINOLARYNGOLOGY Pub Date : 2024-10-23 DOI: 10.4274/tao.2023.2022-9-5
Kalaiarasi Raja, Saranya Thangavel, Akshat Kushwaha, Bheemanathi Hanuman Srinivas, Rakhee Kar, Arun Alexander, Lokesh Kumar Penubarthi, Sunil Kumar Saxena

Objective: This study aims to present a series of patients with disseminated rhinosporidosis with diagnostic and therapeutic features.

Methods: A retrospective study was conducted in a tertiary health care centre in South India from 2007 to 2020 with disseminated rhinosporidiosis. Twelve patients with multiple sites of involvement like the nose, nasopharynx, oropharynx, larynx, lacrimal sac and skin were included in the study. All patients underwent surgical excision, followed by peroral dapsone for one year.

Results: The age group was around 30-55 years, with male predominance (11:1). Pond bathing history was present in 50% (n=6). The most common site of lesion was the nose (100%), oropharynx (83.3%), skin (75%), larynx (50%) and less commonly, nasopharynx (41.6%) and lacrimal sac (25%). One patient underwent surgery four times (8.3%), followed by thrice and twice by five (41.6%) and six (50%) patients, respectively. On two years of follow-up, two patients (16.6%) had a recurrence in the nose and larynx whereas eight patients (66.6%) had no recurrence and two patients (16.6%) were lost to follow-up.

Conclusion: This original article highlights the rare occurrence of disseminated rhinosporidiosis, the possibility of which should be kept in mind, mainly when two or more sites are involved. The most significant number of disseminated rhinosporidiosis cases in the literature is reported here. Dissemination with the cutaneous and multisite disease is rarely reported and poses difficulty in management. Early diagnosis and intervention prevent the dissemination of spores into various parts of the body.

目的本研究旨在介绍一系列播散性鼻孢子虫病患者的诊断和治疗特点:方法:2007 年至 2020 年期间,在印度南部的一家三级医疗保健中心对散发型鼻孢子虫病患者进行了一项回顾性研究。研究纳入了 12 名鼻腔、鼻咽、口咽、喉、泪囊和皮肤等多部位受累的患者。所有患者均接受了手术切除,随后口服达哌酮一年:患者年龄在 30-55 岁之间,男性居多(11:1)。50%的患者(6 人)有池塘沐浴史。最常见的病变部位是鼻子(100%)、口咽(83.3%)、皮肤(75%)、喉(50%),鼻咽(41.6%)和泪囊(25%)较少见。一名患者接受了四次手术(8.3%),随后分别有五名(41.6%)和六名(50%)患者接受了三次和两次手术。在两年的随访中,两名患者(16.6%)在鼻腔和喉部复发,八名患者(66.6%)没有复发,两名患者(16.6%)失去了随访机会:这篇原创文章强调了播散性鼻孢子虫病的罕见性,应牢记其发生的可能性,主要是在涉及两个或两个以上部位时。本文报告了文献中数量最多的播散性鼻孢子虫病病例。皮肤病和多部位疾病的播散很少见报道,给治疗带来了困难。早期诊断和干预可防止孢子扩散到身体的各个部位。
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引用次数: 0
Investigation of Acoustic Voice Characteristics of Individuals Diagnosed with Muscle Tension Dysphonia. 被诊断为肌肉张力性发音障碍者的声音特征调查
IF 0.7 Q4 OTORHINOLARYNGOLOGY Pub Date : 2024-10-23 DOI: 10.4274/tao.2024.2024-3-15
Elife Barmak, Esma Altan, Dilara Söylemez, Emel Çadallı Tatar

Objective: Muscle tension dysphonia (MTD) is a functional voice condition that causes irregular and imbalanced laryngeal and paralaryngeal muscle activation. Our study aimed to examine the acoustic characteristics of patients with MTD and reveal the differences between genders.

Methods: The study retrospectively reviewed the acoustic examination findings from the files of patients diagnosed with MTD during evaluations in the laryngology outpatient clinic at a tertiary reference hospital between 2015 and 2022. The parameters assessed in prolonged vowel phonation analysis were fundamental frequency (F0), jitter, shimmer, noise-to-harmonic-to-ratio, and soft phonation index; in the counting task analysis, they were intensity, frequency, and semitone. Gender differences in acoustic measurements obtained during prolonged vowel phonation and counting tasks were also examined.

Results: The study included 80 individuals diagnosed with MTD. Although all parameters in the acoustic analysis of/a/ phonation were increased, differences were statistically significant only in the F0 and jitter parameters between females and males (p≤0.05). In the analysis of the counting task, the mean and minimum F0 parameters were significantly higher in females than in males (p=0.000). The mean dB level was decreased, particularly in the counting task, but the results for the intensity parameter did not differ significantly between genders (p>0.05).

Conclusion: The values in the acoustic voice analysis parameters of patients with MTD were determined. These acoustic parameters are thought to guide the clinician in evaluating voice and determining voice therapy goals for MTD patients.

目的:肌肉紧张性发音障碍(MTD)是一种功能性嗓音疾病,会导致不规则和不平衡的喉和咽旁肌肉激活。我们的研究旨在检查 MTD 患者的声学特征,并揭示性别差异:本研究回顾性审查了 2015 年至 2022 年间在一家三级甲等参考医院喉科门诊评估期间被诊断为 MTD 的患者档案中的声学检查结果。在延长元音发音分析中,评估的参数包括基频(F0)、抖动、闪烁、噪声-谐波-比率和软发音指数;在计数任务分析中,评估的参数包括强度、频率和半音。研究还考察了长时间元音发音和计数任务中声学测量结果的性别差异:研究共纳入了 80 名被诊断为 MTD 的患者。虽然在元音/a/发音的声学分析中,所有参数都有所增加,但只有在 F0 和抖动参数上,男女之间的差异具有统计学意义(P≤0.05)。在计数任务分析中,女性的平均和最小 F0 参数明显高于男性(p=0.000)。平均分贝水平有所下降,尤其是在数数任务中,但强度参数的结果在性别间没有明显差异(p>0.05):结论:确定了 MTD 患者的声学语音分析参数值。这些声学参数可为临床医生评估嗓音和确定 MTD 患者的嗓音治疗目标提供指导。
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引用次数: 0
Salvage Endoscopic Nasopharyngectomy for Recurrent Nasopharyngeal Cancer: an Institutional Experience. 鼻咽癌复发的抢救性内窥镜鼻咽切除术:机构经验。
IF 0.7 Q4 OTORHINOLARYNGOLOGY Pub Date : 2024-10-23 DOI: 10.4274/tao.2024.2024-1-2
Ergin Eroğlu, A Erim Pamuk, Serdar Özer, Tevfik Metin Önerci

Objective: This study aims to present the surgical and oncological long-term outcomes of patients with locally recurrent nasopharyngeal cancer (NPC) following endoscopic endonasal nasopharyngectomy (EEN).

Methods: The medical records of 11 patients who underwent EEN due to recurrent NPC were retrospectively reviewed.

Results: The mean age of the patient cohort, consisting of 10 males (90.9%) and one female (9.1%), was 44±13.01 years at the time of initial diagnosis. Seven patients (63.7%) had local recurrence, and four patients (36.3%) had loco-regional recurrence. The mean time to first recurrence from the initial diagnosis was 40.3 months, with a 5-year overall survival (OS) rate of 72.7% and a disease-free survival (DFS) rate of 27.3%. There were no significant differences between the concurrent chemoradiotherapy (CRT) and induction chemotherapy+concurrent CRT treatment groups in terms of DFS and OS as a first-line treatment (p=0.645).

Conclusion: EEN is a viable alternative approach for selected cases of locally recurrent NPC, considering the morbidities associated with re-irradiation.

研究目的本研究旨在介绍局部复发性鼻咽癌(NPC)患者在接受内窥镜鼻咽切除术(EEN)后的手术和肿瘤学长期疗效:方法:回顾性审查了11名因鼻咽癌复发而接受鼻内镜鼻咽切除术的患者的病历:结果:患者群中有 10 名男性(90.9%)和 1 名女性(9.1%),初次诊断时的平均年龄为 44±13.01 岁。7名患者(63.7%)局部复发,4名患者(36.3%)局部区域复发。从初诊到首次复发的平均时间为40.3个月,5年总生存(OS)率为72.7%,无病生存(DFS)率为27.3%。作为一线治疗,同期化疗放疗(CRT)组与诱导化疗+同期CRT治疗组在DFS和OS方面无明显差异(P=0.645):考虑到再次放疗带来的发病率,EEN是局部复发鼻咽癌特定病例的可行替代方法。
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引用次数: 0
Evaluating the Performance of ChatGPT, Gemini, and Bing Compared with Resident Surgeons in the Otorhinolaryngology In-service Training Examination. 评估 ChatGPT、Gemini 和 Bing 在耳鼻喉科在职培训考试中与住院外科医生的表现。
IF 0.7 Q4 OTORHINOLARYNGOLOGY Pub Date : 2024-10-23 DOI: 10.4274/tao.2024.3.5
Utku Mete

Objective: Large language models (LLMs) are used in various fields for their ability to produce human-like text. They are particularly useful in medical education, aiding clinical management skills and exam preparation for residents. To evaluate and compare the performance of ChatGPT (GPT-4), Gemini, and Bing with each other and with otorhinolaryngology residents in answering in-service training exam questions and provide insights into the usefulness of these models in medical education and healthcare.

Methods: Eight otorhinolaryngology in-service training exams were used for comparison. 316 questions were prepared from the Resident Training Textbook of the Turkish Society of Otorhinolaryngology Head and Neck Surgery. These questions were presented to the three artificial intelligence models. The exam results were evaluated to determine the accuracy of both models and residents.

Results: GPT-4 achieved the highest accuracy among the LLMs at 54.75% (GPT-4 vs. Gemini p=0.002, GPT-4 vs. Bing p<0.001), followed by Gemini at 40.50% and Bing at 37.00% (Gemini vs. Bing p=0.327). However, senior residents outperformed all LLMs and other residents with an accuracy rate of 75.5% (p<0.001). The LLMs could only compete with junior residents. GPT- 4 and Gemini performed similarly to juniors, whose accuracy level was 46.90% (p=0.058 and p=0.120, respectively). However, juniors still outperformed Bing (p=0.019).

Conclusion: The LLMs currently have limitations in achieving the same medical accuracy as senior and mid-level residents. However, they outperform in specific subspecialties, indicating the potential usefulness in certain medical fields.

目的:大语言模型(LLMs)因其能够生成类人文本而被广泛应用于各个领域。它们在医学教育中尤其有用,可帮助住院医生掌握临床管理技能和备考。目的是评估和比较 ChatGPT (GPT-4)、Gemini 和 Bing 在回答耳鼻喉科住院医师在职培训考试问题时的表现,并深入了解这些模型在医学教育和医疗保健中的实用性:方法:使用八种耳鼻喉科在职培训考试进行比较。从土耳其耳鼻咽喉头颈外科协会的住院医师培训教材中准备了 316 道题。这些问题被提交给三个人工智能模型。对考试结果进行评估,以确定模型和住院医师的准确性:结果:在 LLMs 中,GPT-4 的准确率最高,达到 54.75%(GPT-4 与 Gemini 相比 p=0.002,GPT-4 与 Bing 相比 p):目前,LLM 在达到与中高级住院医师相同的医疗准确性方面存在局限性。不过,他们在特定的亚专科领域表现出色,这表明他们在某些医学领域具有潜在的实用性。
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引用次数: 0
期刊
Turkish Archives of Otorhinolaryngology
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