Brazilian Journal of Otorhinolaryngology最新文献

Impact of smoking and alcohol drinking on the prognosis of 721 nasopharyngeal carcinoma 吸烟和饮酒对 721 例鼻咽癌预后的影响。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-11-19 DOI: 10.1016/j.bjorl.2024.101534

Ling Tian , Min Zhao , Qing Yang , Xiaojiang Li , Yun Chen , Xifang Wu , Yan-Xin Ren

Objective

This study aimed to examine the correlation between smoking, alcohol drinking, and the prognosis of Nasopharyngeal Carcinoma (NPC).

Methods

Clinical data from 721 NPC cases treated at our hospital between January 2005 and December 2010 were collected. Information on smoking and drinking, including duration, daily quantity, and cumulative amount, was recorded and graded according to WHO standards. Statistical analysis was performed to assess the influence of smoking and alcohol drinking on NPC patient prognosis. After controlling for confounding factors, survival analysis compared the 5-year Progression-Free Survival rate (PFS) and Overall Survival rate (OS) among patients with varying degrees of smoking and drinking. The association between smoking, drinking, cumulative amount, and NPC patient prognosis was evaluated. Multivariate Cox regression analysis was then employed, considering patient demographic characteristics and clinical features, to comprehensively analyze prognostic influencing factors in NPC patients. Additionally, the multivariate Cox regression analysis was utilized to comprehensively examine the influencing factors of prognosis, taking into account the patients' basic demographic characteristics and clinical features. The findings revealed significant differences in the aforementioned rates.

Results

(1) Analysis of PFS and OS differences in NPC patients considered smoking status, smoking duration, daily smoking quantity, and cumulative smoking amount. No significant influence of smoking on NPC patient PFS and OS within 5-years was observed (p > 0.05). (2) Non-drinkers with NPC exhibited higher 5-year PFS and OS rates compared to drinkers (p = 0.047, p = 0.026). Furthermore, non-drinkers and those with a drinking duration of less than 120 months or between 120–240 months showed higher 5-year PFS and OS rates than individuals with a drinking duration exceeding 240 months (p < 0.05). Similarly, non-drinkers and individuals consuming less than 50 g/day had higher 5-year PFS and OS rates compared to those consuming 50–100 g/day or more than 100 g/day (p < 0.05). Additionally, the 5-year PFS and OS rates were higher in the non-drinking and light drinking groups compared to the moderate and heavy drinking groups (p < 0.05). (3) A partial synergistic effect between smoking and alcohol drinking was observed in NPC. (4) Alcohol drinking emerged as an independent prognostic factor for NPC.

Conclusion

Alcohol drinking is a significant factor influencing the prognosis of nasopharyngeal carcinoma, with the adverse effects further amplified when combined with smoking.

Level of evidence

Level 2.

目的：本研究旨在探讨吸烟、饮酒与鼻咽癌预后的相关性：本研究旨在探讨吸烟、饮酒与鼻咽癌（NPC）预后之间的相关性：方法：收集我院 2005 年 1 月至 2010 年 12 月间收治的 721 例鼻咽癌患者的临床数据。记录了吸烟和饮酒的信息，包括持续时间、每日数量和累计数量，并根据世界卫生组织的标准进行了分级。统计分析评估了吸烟和饮酒对鼻咽癌患者预后的影响。在控制了混杂因素后，生存分析比较了不同吸烟和饮酒程度患者的 5 年无进展生存率（PFS）和总生存率（OS）。评估了吸烟、饮酒、累积量与鼻咽癌患者预后之间的关系。然后，在考虑患者人口统计学特征和临床特征的基础上，采用多变量 Cox 回归分析，全面分析影响鼻咽癌患者预后的因素。此外，考虑到患者的基本人口学特征和临床特征，采用多变量 Cox 回归分析法全面研究预后的影响因素。结果：(1) 分析鼻咽癌患者的 PFS 和 OS 差异时，考虑了吸烟状态、吸烟时间、每日吸烟量和累计吸烟量。未观察到吸烟对鼻咽癌患者 5 年内的 PFS 和 OS 有明显影响（P > 0.05）。(2）与饮酒者相比，非饮酒者的鼻咽癌患者的 5 年生存率和手术率更高（P = 0.047，P = 0.026）。此外，与饮酒时间超过 240 个月的个体相比，非饮酒者和饮酒时间少于 120 个月或介于 120-240 个月之间的个体显示出更高的 5 年生存率和 OS 率（p 结论：饮酒是鼻咽癌的一个重要因素：饮酒是影响鼻咽癌预后的一个重要因素，如果合并吸烟，其不利影响会进一步扩大：证据等级：2 级。

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引用次数: 0

Rehabilitation after supracricoid partial laryngectomy: cohort study 环上型喉部分切除术后的康复：队列研究。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-11-19 DOI: 10.1016/j.bjorl.2024.101532

Caroline da Silva Seidler, Marianne Yumi Nakai, Lucas Ribeiro Tenório, Daniela Serrano Marquezin, Renata Santos Bittencourt Silva, Marcelo Benedito Menezes, Antonio José Gonçalves

Objectives

To evaluate vocal, swallowing and respiratory rehabilitation of patients undergoing supracricoid laryngectomy; evaluate the impact of voice changes and global quality of life.

Methods

It is a prospective cohort study where voice, swallowing and respiratory rehabilitation where evaluated. Quality of life was assessed using EORTC QLQ-C30 and H&N35 questionnaires.

Results

31 patients were included in the study. 70.4% of patients were T3. In swallowing assessment, two patients (6.4%) were considered non-rehabilitated. Ten patients (32.2%) were considered partially rehabilitated and 19 (61.3%) fully rehabilitated. Sensitivity was abnormal at 74.2%. Penetration occurred in 58.1% of patients with 29% experiencing aspiration. In voice assessment, 19 (61.3%) patients were considered rehabilitated. 77.41% had a calculated voice handicap index considered abnormal. When assessing breathing, eight patients (25.8%) were considered non-rehabilitated. Disease-free survival was 87.1% in follow-up of 5.77 years. When subjected to specific exams and evaluations, only 38.7% were completely rehabilitated. When comparing results of EORTC-C30 and H&N35 questionnaires with the reference values, global score and domain scores are better on the patients of the study, as well as some of the symptoms.

Conclusion

Partial supracricoid laryngectomy remains an option in patients with laryngeal tumors, especially in the most advanced ones, with a survival rate around 90%. Quality of life is impacted after surgery, but with few symptoms.

Level of evidence

Level 3.¹

目的评估环状喉上切除术患者的嗓音、吞咽和呼吸康复情况；评估嗓音变化的影响和整体生活质量：这是一项前瞻性队列研究，对嗓音、吞咽和呼吸康复进行评估。采用 EORTC QLQ-C30 和 H&N35 问卷评估生活质量：研究共纳入 31 名患者。70.4% 的患者为 T3。在吞咽评估中，有两名患者（6.4%）被认为未康复。10名患者（32.2%）被视为部分康复，19名患者（61.3%）被视为完全康复。灵敏度异常，为 74.2%。58.1%的患者出现穿透，29%的患者出现吸入。在语音评估中，19 名患者（61.3%）被认为已经康复。77.41%的患者经计算后认为嗓音障碍指数异常。在评估呼吸时，8 名患者（25.8%）被认为未康复。在5.77年的随访中，无病生存率为87.1%。在接受特定检查和评估时，只有 38.7% 的患者完全康复。如果将 EORTC-C30 和 H&N35 问卷的结果与参考值进行比较，本研究中患者的总体评分和领域评分以及某些症状的评分都更高：结论：环状上喉部分切除术仍是喉肿瘤患者的一种选择，尤其是晚期喉肿瘤患者，其生存率约为90%。术后生活质量会受到影响，但症状较少：证据等级：3.1级。

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引用次数: 0

Validation and reproducibility of the International Study of Asthma and Allergies in Childhood (ISAAC) Written Allergic Rhinitis Questionnaire for phone survey in children aged 6‒7 years 国际儿童哮喘和过敏症研究 (ISAAC) 用于 6-7 岁儿童电话调查的过敏性鼻炎书面问卷的验证和再现性。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-11-19 DOI: 10.1016/j.bjorl.2024.101531

Priscilla Campos , Solange O.R. Valle , Antônio José Ledo Alves da Cunha , Fábio Chigres Kuschnir , Dirceu Solé

Objective

To validate and assess the reproducibility of the ISAAC Written Allergic Rhinitis Questionnaire (WARQ) for children aged between 6 and 7 years by telephone contact.

Methods

Observational study through interviews with guardians of children aged 6–7 years using the ISAAC Allergic Rhinitis (AR) module questionnaire in three different phases separated by 2 weeks each: telephone interviews in the first and third contacts and face-to-face interviews, with the same guardian of telephone interviews, in the second contact. Reproducibility was estimated using the Kappa index and validation using the sensitivity and specificity coefficients.

Results

Data from 94 children (48 from the allergic rhinitis Control Group ‒ CG) were analyzed. Reproducibility showed perfect agreement (100%) for the question number 1 – Which refers to the symptoms of AR, ever: “Has your child ever had a problem with sneezing or a runny or a blocked nose when he/she did not have a cold or the flu?” and for the question number 2 – Which refers to current symptoms of AR: “In the past 12 months, has your child had a problem with sneezing or a runny or a blocked nose when he/she did not have a cold or the flu?” A strong agreement was also observed for the question number 3 (κ = 0.871) – it defines the presence of comorbidity of allergic rhinoconjuntivitis “In the past 12 months, has this nose problem been accompanied by itchy-watery eyes?” The validation showed high specificity (≥76.7%) and sensitivity (≥98%) for all questions, except for the ones related to seasonality and intensity of symptoms.

Conclusions

Our results showed that the ISAAC AR module questionnaire by telephone interviews has good reproducibility and high agreement with the clinical diagnosis of AR. It may be an appropriate alternative tool in epidemiological studies of childhood AR, especially in periods of social isolation, such as Coronavirus pandemic.

Level of evidence

Cohort Study. Level IV

目的通过电话联系，验证和评估针对6至7岁儿童的ISAAC过敏性鼻炎书面问卷（WARQ）的可重复性：通过对 6-7 岁儿童监护人的访谈进行观察研究，使用 ISAAC 过敏性鼻炎 (AR) 模块问卷，分三个不同阶段进行，每个阶段间隔 2 周：第一次和第三次联系时进行电话访谈，第二次联系时与电话访谈的同一监护人进行面对面访谈。再现性采用卡帕指数估算，验证性采用灵敏度和特异性系数估算：分析了 94 名儿童（48 名来自过敏性鼻炎对照组--CG）的数据。可重复性显示，在问题 1（指曾经出现过的 AR 症状）"您的孩子在没有伤风感冒的情况下，是否曾经出现过打喷嚏、流鼻涕或鼻塞的问题？第 3 个问题（κ = 0.871）也具有很高的一致性--它定义了是否存在过敏性鼻并发症："在过去 12 个月中，这种鼻部问题是否伴有眼睛发痒流泪？验证结果显示，除了与季节性和症状强度有关的问题外，所有问题的特异性（≥76.7%）和敏感性（≥98%）都很高：我们的研究结果表明，通过电话访问进行的 ISAAC AR 模块问卷与 AR 的临床诊断具有良好的重现性和高度一致性。在儿童 AR 的流行病学研究中，尤其是在冠状病毒大流行等社会隔离时期，它可能是一种合适的替代工具：证据等级：队列研究：

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引用次数: 0

Can anatomy-based fitting improve musical perception in adult cochlear implant users? 基于解剖学的适配能否改善成年人工耳蜗用户的音乐感知？

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-11-19 DOI: 10.1016/j.bjorl.2024.101533

Luis Lassaletta , Miryam Calvino , Isabel Sánchez-Cuadrado , Elena Muñoz , Javier Gavilán

Objectives

To compare Anatomy-Based Fitting (ABF) vs. Default Fitting (DF) in terms of music perception and music enjoyment in CI users.

Methods

CI users ≥ 18 years implanted with a Synchrony ST Flex28 (MEDEL) with at least 12 months of experience with either ABF or DF, with good speech tests outcomes (≥ 65% disyllables) were enrolled. Music tasks were assessed with “Discovery” level of Meludia online interactive music tool, which includes Rhythm (beat count), Spatialization (differentiating between lower and higher notes), Stable/unstable (perception of stability or instability), Melody (ascendant or descendant), and Density (presence of one or multiple simultaneous sounds). Each task consists of five levels of difficulty. Participants were allowed a maximum of 4 attempts to complete a level. The Music-Related Quality of Life (MuRQoL) and the Munich Music (MUMU) questionnaires evaluated music background.

Results

Twenty CI users took part: 10 using ABF and 10 DF. There were no significant differences in age at implantation (53.2 ± 15.0 vs. 53.8 ± 14.5y), time since surgery (1.8 ± 0.5 vs. 2.4 ± 1.5y), or the percentage of disyllables in silence (68.0 ± 8.0 vs. 77.3 ± 11.5%) between groups. Regarding Meludia scores, differences were observed between both groups in Density: ABF had better mean scores when completing the level in only one attempt (8.7 ± 2.5 vs. 4.6 ± 3.1, p = 0.016) and required fewer restarts to complete the five levels (6.6 ± 1.6 vs. 9.3 ± 2.3; p = 0.009). Furthermore, the fifth level of Density was successfully completed by 60% of patients with ABF, while none of the patients with DF achieved this (p = 0.003). The scores obtained in MuRQoL were similar between ABF and DF groups. In a similar way, the MUMU showed no differences in terms of frequency and music importance.

Conclusions

ABF demonstrates specific advantages in certain musical tasks, specifically in processing multiple sounds simultaneously. Further studies are necessary to explore additional benefits of ABF in musical skills in CI users. NCT05319678.

Level of evidence

Level 3.

目的比较基于解剖的装配（ABF）与默认装配（DF）对 CI 用户音乐感知和音乐享受的影响：方法：招募年龄≥ 18 岁、植入 Synchrony ST Flex28 (MEDEL)、使用 ABF 或 DF 至少 12 个月、语音测试结果良好（双音节率≥ 65%）的 CI 用户。音乐任务使用 Meludia 在线互动音乐工具的 "发现 "级别进行评估，包括节奏（节拍计数）、空间化（区分低音和高音）、稳定/不稳定（感知稳定或不稳定）、旋律（升调或降调）和密度（同时出现一个或多个声音）。每项任务由五个难度级别组成。参与者最多可尝试 4 次完成一个级别。音乐相关生活质量（MuRQoL）和慕尼黑音乐（MUMU）问卷对音乐背景进行了评估：结果：20 名 CI 用户参加了调查：10 人使用 ABF，10 人使用 DF。植入时的年龄（53.2 ± 15.0 岁 vs. 53.8 ± 14.5 岁）、手术后的时间（1.8 ± 0.5 岁 vs. 2.4 ± 1.5 岁）或静音时的双音节百分比（68.0 ± 8.0% vs. 77.3 ± 11.5%）在各组间无明显差异。关于 Meludia 分数，两组之间在密度上存在差异：ABF 组在只尝试一次就完成该级别时平均得分更高（8.7 ± 2.5 vs. 4.6 ± 3.1，p = 0.016），在完成五个级别时需要重新开始的次数更少（6.6 ± 1.6 vs. 9.3 ± 2.3；p = 0.009）。此外，60% 的 ABF 患者成功完成了第五级密度，而 DF 患者则无一成功完成（p = 0.003）。ABF 组和 DF 组的 MuRQoL 得分相似。同样，MUMU 在频率和音乐重要性方面也没有显示出差异：结论：ABF 在某些音乐任务中，尤其是在同时处理多种声音方面表现出了特殊的优势。有必要开展进一步研究，探索 ABF 对 CI 用户音乐技能的其他益处。NCT05319678.证据等级：3级。

{"title":"Can anatomy-based fitting improve musical perception in adult cochlear implant users?","authors":"Luis Lassaletta , Miryam Calvino , Isabel Sánchez-Cuadrado , Elena Muñoz , Javier Gavilán","doi":"10.1016/j.bjorl.2024.101533","DOIUrl":"10.1016/j.bjorl.2024.101533","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare Anatomy-Based Fitting (ABF) vs. Default Fitting (DF) in terms of music perception and music enjoyment in CI users.</div></div><div><h3>Methods</h3><div>CI users ≥ 18 years implanted with a Synchrony ST Flex28 (MEDEL) with at least 12 months of experience with either ABF or DF, with good speech tests outcomes (≥ 65% disyllables) were enrolled. Music tasks were assessed with “Discovery” level of Meludia online interactive music tool, which includes Rhythm (beat count), Spatialization (differentiating between lower and higher notes), Stable/unstable (perception of stability or instability), Melody (ascendant or descendant), and Density (presence of one or multiple simultaneous sounds). Each task consists of five levels of difficulty. Participants were allowed a maximum of 4 attempts to complete a level. The Music-Related Quality of Life (MuRQoL) and the Munich Music (MUMU) questionnaires evaluated music background.</div></div><div><h3>Results</h3><div>Twenty CI users took part: 10 using ABF and 10 DF. There were no significant differences in age at implantation (53.2 ± 15.0 vs. 53.8 ± 14.5y), time since surgery (1.8 ± 0.5 vs. 2.4 ± 1.5y), or the percentage of disyllables in silence (68.0 ± 8.0 vs. 77.3 ± 11.5%) between groups. Regarding Meludia scores, differences were observed between both groups in Density: ABF had better mean scores when completing the level in only one attempt (8.7 ± 2.5 vs. 4.6 ± 3.1, <em>p</em> = 0.016) and required fewer restarts to complete the five levels (6.6 ± 1.6 vs. 9.3 ± 2.3; <em>p</em> = 0.009). Furthermore, the fifth level of Density was successfully completed by 60% of patients with ABF, while none of the patients with DF achieved this (<em>p</em> = 0.003). The scores obtained in MuRQoL were similar between ABF and DF groups. In a similar way, the MUMU showed no differences in terms of frequency and music importance.</div></div><div><h3>Conclusions</h3><div>ABF demonstrates specific advantages in certain musical tasks, specifically in processing multiple sounds simultaneously. Further studies are necessary to explore additional benefits of ABF in musical skills in CI users. NCT05319678.</div></div><div><h3>Level of evidence</h3><div>Level 3.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 2","pages":"Article 101533"},"PeriodicalIF":1.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development and internal validation of risk stratification tool for lymph node metastasis in pT3-4 laryngeal squamous cell carcinoma patients pT3-4喉鳞状细胞癌患者淋巴结转移风险分层工具的开发与内部验证

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-11-18 DOI: 10.1016/j.bjorl.2024.101535

Changding He , Yu Heng , Xiaoke Zhu, Jian Zhou, Lei Tao

Objective

To identify risk factors for Lymph Node Metastasis (LNM) in pT3-4 Laryngeal Squamous Cell Carcinoma (LSCC) patients with negative margins, and develop a nomogram to predict LNM risk.

Methods

872 patients were divided into training (2010–2014) and validation (2015–2016) cohorts. Univariate and multivariate analyses identified LNM risk factors. A nomogram incorporating significant factors was developed in the training cohort.

Results

Smoking history, maximal tumor diameter ≥3.0 cm, depth of tumor invasion >1.0 cm, and supraglottic tumor location were significantly associated with LNM on multivariate analysis. A predictive nomogram incorporating these factors showed good discrimination (C-index > 0.7) in both cohorts. Patients were stratified into low, moderate and high-risk subgroups based on total risk scores.

Conclusions

A LNM risk prediction model and risk grouping system was established, which may aid treatment selection for pT3-4 LSCC patients. The model and algorithm could help optimize neck management for this high-risk patient population.

Level of evidence

2.

目的方法：将872例患者分为训练组（2010-2014年）和验证组（2015-2016年）。单变量和多变量分析确定了LNM风险因素。在训练队列中绘制了包含重要因素的提名图：结果：在多变量分析中，吸烟史、肿瘤最大直径≥3.0厘米、肿瘤侵犯深度>1.0厘米和声门上肿瘤位置与LNM显著相关。包含这些因素的预测提名图在两个队列中均显示出良好的区分度（C 指数 > 0.7）。根据总风险评分将患者分为低、中和高风险亚组：建立了LNM风险预测模型和风险分组系统，可帮助pT3-4 LSCC患者选择治疗方法。该模型和算法有助于优化这一高风险患者群体的颈部管理：

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引用次数: 0

Risk factors for cervical lymph node metastasis in oropharyngeal cancer and its impact on prognosis 口咽癌颈淋巴结转移的风险因素及其对预后的影响

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-11-05 DOI: 10.1016/j.bjorl.2024.101520

Li Zhang , Zhilin Li , Jing Wang , Chen Wang , Shuxin Wen

Objective

To understand the characteristics of cervical lymph node metastasis in Oropharyngeal Squamous Cell Carcinoma (OPSCC) patients, explore the risk factors for lymph node metastasis, and its impact on prognosis.

Methods

Retrospective cohort study. Statistical analysis of the relationship between various clinicopathological factors and lymph node involvement, as well as the independent risk factors affecting lymph node metastasis and their impact on prognosis.

Results

The cervical lymph node metastasis rate in this group was 89.2%, with the palatine tonsils and base of the tongue more prone to cervical lymph node metastasis (p = 0.007); lower pathological differentiation of OPSCC was more likely to develop cervical lymph node metastasis (p = 0.017). The P16 protein positive rate in this group was 58.8%. P16 protein expression did not affect the incidence rate of cervical lymph node metastasis in OPSCC (p = 1.000) but influenced the risk of multiple lymph node metastases (p = 0.011) and was a risk factor affecting the prognosis of OPSCC (p = 0.003). However, the lymph node metastasis status did not affect the survival time of OPSCC patients.

Conclusion

In the Shanxi region of China, HPV-related OPSCC accounts for a higher proportion; OPSCC has a high rate of cervical lymph node metastasis, but lymph node metastasis does not significantly increase the mortality risk of OPSCC patients, which may be related to the unique characteristics of HPV-related OPSCC.

Level of Evidence Ⅳ

Retrospective cohort study.

目的了解口咽鳞癌（OPSCC）患者颈淋巴结转移的特征，探讨淋巴结转移的风险因素及其对预后的影响：方法：回顾性队列研究。统计分析各种临床病理因素与淋巴结受累的关系，以及影响淋巴结转移的独立危险因素及其对预后的影响：本组患者的颈淋巴结转移率为89.2%，其中腭扁桃体和舌根部更容易发生颈淋巴结转移（P=0.007）；病理分化较低的OPSCC更容易发生颈淋巴结转移（P=0.017）。该组患者的P16蛋白阳性率为58.8%。P16 蛋白表达不影响 OPSCC 的宫颈淋巴结转移发生率（p=1.000），但影响多淋巴结转移的风险（p=0.011），并且是影响 OPSCC 预后的风险因素（p=0.003）。然而，淋巴结转移状态并不影响OPSCC患者的生存时间：结论：在中国山西地区，HPV相关OPSCC所占比例较高；OPSCC的宫颈淋巴结转移率较高，但淋巴结转移并不会显著增加OPSCC患者的死亡风险，这可能与HPV相关OPSCC的特殊性有关。证据级别Ⅳ：回顾性队列研究。

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引用次数: 0

Effectiveness of hypertonic saline irrigation following functional endoscopic sinus surgery: a systematic review and meta-analysis 功能性内窥镜鼻窦手术后高渗盐水冲洗的效果：系统综述和荟萃分析

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-11-05 DOI: 10.1016/j.bjorl.2024.101517

Adriano Damasceno Lima , Rodolfo Baptista Giffoni , Julieta Arguelles-Hernandez , Gabriele Santos , Victor L.J.C. Sena , Ricardo S. Aguiar , Marcelo L.S. Cruz , Maria E.P. Dalmaschio , Marcio Nakanishi

Objectives

This study aimed to clarify the impact of hypertonic solutions on various outcomes, including persistence or reduction of nasal crusts, polypoid edema, and postoperative inflammatory symptoms.

Methods

We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for studies comparing hypertonic with isotonic saline irrigation after FESS in adult patients with Chronic Rhinosinusitis (CRS). Outcomes were polypoid mucosa, nasal crusts, and variation from the baseline of Sino-Nasal Outcome Test (SNOT) 20/22 and Visual Analog Scale (VAS). For statistical analysis, we used RevMan 5.4.1, and assessed heterogeneity with I² statistics.

Results

We included a total of 479 patients from 7 studies. In the hypertonic saline group, there was a reduction in the nasal crust Risk Ratio (RR) (RR = 0.65; 95% CI 0.49 to 0.87; p = 0.004; I² = 0%) after 30–45 days and severe crusts at 14–21 days (RR = 0.59; 95% CI 0.38 to 0.91; p = 0.02; I² = 0%). Additionally, the persistence of polypoid mucosa was lower in the intervention arm (RR = 0.53; 95% CI 0.43 to 0.65; p < 0.00001; I² = 0%) after 14–21 days. In the symptomatic evaluation hypertonic saline group showed an improvement in postoperative symptoms by a VAS Mean Difference (MD) (MD = −5; 95% CI −5.77 to −4.24; p < 0.00001; I² = 0%) and a SNOT 20/22 Standard Mean Difference (SMD) (SMD = −1.65; 95% CI −2.7 to −0.61; p = 0.002; I² = 93%) reduction from baseline in 30–45 days after the surgery.

Conclusion

Hypertonic saline showed a superior improvement in postoperative evaluation by means of nasal crusting, mucosal healing aspect, and nasal inflammatory symptoms compared with isotonic saline irrigation.

本研究旨在阐明高渗溶液对各种结果的影响，包括鼻痂、息肉样水肿和术后炎症症状的持续或减轻。方法我们检索了 PubMed、Embase 和 Cochrane Central Register of Controlled Trials 等文献，比较了慢性鼻窦炎（CRS）成人患者 FESS 术后高渗和等渗生理盐水灌洗的研究。研究结果包括息肉状粘膜、鼻腔结痂、中鼻结果测试（SNOT）20/22 和视觉模拟量表（VAS）与基线的差异。我们使用 RevMan 5.4.1 进行了统计分析，并用 I2 统计量评估了异质性。在高渗盐水组中，30-45 天后鼻痂风险比 (RR) 降低（RR = 0.65；95% CI 0.49 至 0.87；p = 0.004；I2 = 0%），14-21 天后严重鼻痂风险比降低（RR = 0.59；95% CI 0.38 至 0.91；p = 0.02；I2 = 0%）。此外，14-21 天后，干预组的息肉状粘膜持续性较低（RR = 0.53；95% CI 0.43 至 0.65；p < 0.00001；I2 = 0%）。在症状评估中，高渗盐水组的术后症状有所改善，VAS平均差（MD）（MD = -5; 95% CI -5.77 to -4.24; p < 0.00001; I2 = 0%）和SNOT 20/22标准平均差（SMD）（SMD = -1.65; 95% CI -2.7 to -0.结论与等渗盐水灌洗相比，高渗盐水通过鼻腔结痂、粘膜愈合方面和鼻腔炎症症状对术后评估有更好的改善作用。

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引用次数: 0

Impact of hearing impairment on cognitive performance 听力障碍对认知能力的影响。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-11-05 DOI: 10.1016/j.bjorl.2024.101521

Pedro Ivo Machado Pires de Araújo , Pauliana Lamounier e Silva Duarte , Hugo Valter Lisboa Ramos , Claudiney Cândido Costa , Isabela Gomes Maldi , Lucas da Silva Braz , Norma de Oliveira Penido

Objective

This study aims to evaluate the cognitive performance in adults with hearing loss and to identify associations between clinical characteristics of hearing loss and cognitive outcomes.

Methods

In this cross-sectional analytical observational study, adults with hearing loss underwent the Mini-Mental State Examination (MMSE), following the collection of their clinical and audiometric data.

Results

Among 134 evaluated individuals, a majority reported a progressive onset (91.04%) and bilateral nature (87.31%) of hearing loss, with moderate hearing loss being the most common (41.04%). Sensorineural hearing loss was prevalent in 76.12% of cases, with presbycusis identified as a primary etiology in 37.31%. Comorbidities were reported in 61.19% of participants, with 16.42% using benzodiazepines or antidepressants regularly. Symptoms included imbalance (33.58%), vertigo (42.54%), and tinnitus (73.88%). Notably, a sudden onset of hearing loss and imbalance complaints were linked to a higher likelihood of subnormal MMSE performance. Analysis revealed varied cognitive domain performances associated with different clinical characteristics of hearing loss.

Conclusion

Various aspects of hearing loss, such as bilateral and sensorineural types, and the presence of symptoms like tinnitus and vertigo, significantly influence cognitive performance. Specifically, sudden onset hearing loss and imbalance complaints are associated with poorer overall cognitive outcomes in the MMSE. These findings underscore the importance of considering the diverse impacts of hearing loss characteristics on cognitive functions.

Level of evidence

Level 4.

研究目的本研究旨在评估听力损失成年人的认知能力，并确定听力损失的临床特征与认知结果之间的关联：在这项横断面分析观察研究中，成年听力损失患者在收集了临床和听力数据后接受了迷你智力状态检查（MMSE）：在 134 名接受评估的人中，大多数人的听力损失是渐进性的（91.04%）和双侧性的（87.31%），其中中度听力损失最为常见（41.04%）。76.12%的病例普遍存在感音神经性听力损失，37.31%的病例的主要病因是老花眼。61.19%的参与者患有合并症，16.42%的参与者经常使用苯二氮卓类药物或抗抑郁药物。症状包括失衡（33.58%）、眩晕（42.54%）和耳鸣（73.88%）。值得注意的是，突然出现听力损失和失衡症状与 MMSE 成绩低于正常水平的可能性较高有关。分析表明，不同的听力损失临床特征会导致不同的认知领域表现：结论：听力损失的各个方面，如双侧听力损失和感音神经性听力损失，以及耳鸣和眩晕等症状的存在，都会对认知能力产生重大影响。具体而言，突发性听力损失和失衡主诉与 MMSE 的整体认知结果较差有关。这些发现强调了考虑听力损失特征对认知功能的不同影响的重要性：证据等级：4级。

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引用次数: 0

Perineural invasion and laryngeal squamous cell carcinoma: a systematic review 硬膜外侵犯与喉鳞状细胞癌：系统综述。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-11-01 DOI: 10.1016/j.bjorl.2024.101519

Debora Modelli Vianna Ocampo Quintana , Rogerio Aparecido Dedivitis , Luiz Paulo Kowalski

Objectives

Several studies have evaluated the prognostic significance of Perineural Invasion (IPN) in laryngeal cancer; however, the results are non-conclusive. Therefore, we conducted a meta-analysis aiming to identify the prognostic value of IPN in laryngeal cancer.

Methods

A literature review was performed, searching MedLine via PubMed, Scielo, Lilacs, Cochrane and Websco. RevMan 5.4 was used for the statistical analysis.

Results

A total of 19 laryngeal cancer studies were included. The results indicate that IPN in laryngeal cancer shows 2-year survival with RR 0.71 (0.59‒0.86); disease-free survival RR 0.51 (0.14–1.95); and locoregional recurrence RR 1.71 (1.25–2.35).

Conclusion

IPN is a negative prognostic factor in laryngeal cancer.

研究目的有几项研究评估了喉癌神经周围侵犯（IPN）的预后意义，但结果尚无定论。因此，我们进行了一项荟萃分析，旨在确定 IPN 在喉癌中的预后价值：方法：通过PubMed、Scielo、Lilacs、Cochrane和Websco检索MedLine，进行文献综述。统计分析使用 RevMan 5.4：结果：共纳入 19 项喉癌研究。结果显示，IPN在喉癌中的2年生存率为RR 0.71（0.59-0.86）；无病生存率为RR 0.51（0.14-1.95）；局部复发率为RR 1.71（1.25-2.35）：结论：IPN是喉癌的不良预后因素。

引用次数: 0

Robotic-assisted cochlear implant surgery 机器人辅助人工耳蜗植入手术

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-11-01 DOI: 10.1016/j.bjorl.2024.101530

Vagner Antonio Rodrigues Silva, Arthur Menino Castilho

引用次数: 0