Brazilian Journal of Otorhinolaryngology最新文献

{"title":"The emerging role of platelet-rich plasma subepithelial infusion for vocal fold scar, sulcus, and atrophy","authors":"Gustavo Polacow Korn , Michal M. Johns III","doi":"10.1016/j.bjorl.2025.101716","DOIUrl":"10.1016/j.bjorl.2025.101716","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101716"},"PeriodicalIF":1.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generative artificial intelligence in otorhinolaryngology: From innovation to public health transformation","authors":"Alexandre Vallée","doi":"10.1016/j.bjorl.2025.101714","DOIUrl":"10.1016/j.bjorl.2025.101714","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101714"},"PeriodicalIF":1.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal analysis of the impact of serum 25-hydroxyvitamin D levels on laryngeal cancer: A two-sample mendelian randomization study","authors":"Bo Li ,&nbsp;Cuiping She","doi":"10.1016/j.bjorl.2025.101705","DOIUrl":"10.1016/j.bjorl.2025.101705","url":null,"abstract":"<div><h3>Objective</h3><div>The levels of vitamin D in the human body are primarily measured through serum 25-hydroxyvitamin D (25(OH)D) levels. Observational studies suggest a potential association between the incidence of laryngeal cancer and vitamin D levels, but the causality remains unclear. This study aims to investigate the potential causal relationship between vitamin D levels and laryngeal cancer.</div></div><div><h3>Methods</h3><div>This Mendelian Randomization (MR) study is based on large-scale GWAS (Genome-Wide Association Study) summary datasets. We selected two different datasets of 25(OH)D and conducted two two-sample univariable Mendelian Randomization (MR) analyses. Four different MR methods were applied, and a series of sensitivity analyses were performed. In addition, a two-sample Mendelian randomization was conducted to account for the confounding effect of smoking. Furthermore, we performed GO enrichment analyses on the SNPs used as instrumental variables.</div></div><div><h3>Results</h3><div>The combined findings from both univariable MR analyses support a potential causal relationship between serum 25(OH)D levels and laryngeal cancer, suggesting that higher levels of vitamin D may have a protective effect against laryngeal cancer. Multivariable MR analysis showed that even after accounting for smoking as a confounding factor, the impact of 25(OH)D on laryngeal cancer remained significant. Enrichment analysis further indicated that 25(OH)D may inhibit the occurrence and progression of laryngeal cancer by regulating the metabolism of exogenous substances, lipid metabolism, and cellular responses to environmental stimuli.</div></div><div><h3>Conclusion</h3><div>Higher serum 25-hydroxyvitamin D levels serve as a protective factor against laryngeal cancer, suggesting that increasing vitamin D levels may reduce the risk of laryngeal cancer.</div></div><div><h3>Level of evidence</h3><div>This was a Mendelian randomized study with a level of evidence second only to clinical randomized trials, and higher than cohort and case-control studies.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101705"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cochlear size variation among the Argentinian population","authors":"Maria Fernanda Di Gregorio ,&nbsp;Ana Celeste Ferrari ,&nbsp;Anandhan Dhanasingh ,&nbsp;Maximo Zernotti ,&nbsp;Mario Zernotti","doi":"10.1016/j.bjorl.2025.101708","DOIUrl":"10.1016/j.bjorl.2025.101708","url":null,"abstract":"<div><h3>Objective</h3><div>Cochlear size, shape and the anatomy vary a lot among the human population. Cochlear size is a clinically useful parameter to determine the suitable cochlear implant electrode length. Objective is to assess the cochlear size and shape variation among the Argentine population.</div></div><div><h3>Methods</h3><div>Computer Tomography (CT) scans of 247 ears were assessed for the cochlear parameters including basal turn diameter (A-value) and width (B-value) and the cochlear height in the mid-modiolar section (H-value) using OTOPLAN® version 4.0. Shape of cochlear basal turn was determined by the ratio between B- and A-values. Cochlear Duct Length (CDL) was estimated from the A-, and B-values.</div></div><div><h3>Results</h3><div>The A-value was found to vary between 6.7 mm and 10.1 mm with a mean value of 8.7 ± 0.61 mm and the B-value was found to vary between 4.5 mm and 8.1 mm with a mean value of 6.4 ± 0.57 mm. The cochlear height as measured in the axial view from the mid-modiolar section was 3.78 ± 0.57 mm. Shape of the cochlear basal turn as determined by the ratio between B- and A-values showed 41 out of 248 ears (16.5%) have more of a round shaped basal turn with the ratio of ≥0.75 leaving the remaining 207 ears (83.5%) with more of an elliptical shaped basal turn. CDL was found to vary between 24.5 mm and 41.2 mm with a median value of 33.6 mm.</div></div><div><h3>Conclusion</h3><div>Argentine population appears to have slightly smaller cochlear size compared to population from other countries as reported in literature.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101708"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High frequency of balance abnormalities in Turner syndrome","authors":"Vanessa Brito Campoy Rocha ,&nbsp;Raquel Mezzalira ,&nbsp;Guita Stoler ,&nbsp;Gil Guerra-Junior ,&nbsp;Sofia Helena Valente de Lemos-Marini ,&nbsp;Andréa Trevas Maciel-Guerra","doi":"10.1016/j.bjorl.2025.101713","DOIUrl":"10.1016/j.bjorl.2025.101713","url":null,"abstract":"<div><h3>Objective</h3><div>To perform a thorough evaluation of body balance in Turner Syndrome, adding evidence to the already scarce data in literature regarding labyrinth impairment in these patients.</div></div><div><h3>Methods</h3><div>Adolescent and adult patients and a control group of healthy women were subject to otolaryngological, audiological, and vestibular evaluations. The latter included electronystagmography with caloric and rotational testing, cervical vestibular-evoked myogenic potential and static posturography with dynamic tests.</div></div><div><h3>Results</h3><div>Twenty-seven patients aged 15–33 years (mean: 21.9-years) were evaluated. Karyotype was 45,X in 13/27 cases. Dizziness was reported in eight patients and progressive hearing loss in ten. Audiometry was abnormal in 13/27 cases, six of them sensorineural, six conductive, and one with a mixed pattern. A balance abnormality was found in 21/27 patients (78%). Nineteen patients had vestibular lesion, [12 peripheral (57%), four combined (19%), three central (11%)] and two had only somatosensorial deficit. Non-vestibular abnormalities were found in 6 (22%) patients, five with somatosensorial deficit and one with visual dependence. Balance abnormalities were neither associated with karyotype (45,X vs. other karyotypes) nor with hearing impairment. Control group comprised 20 healthy women aged 27–35 years (mean: 30.5 years); 4/20 (25%) had a balance abnormality, two peripheral and two central causes, a frequency significantly lower than that of TS patients (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Despite the low frequency of self-reported vestibular and auditory symptoms, this study reveals a high rate of inner ear involvement among women with TS, in which both auditory and vestibular pathways are frequently affected, often in a subclinical or compensated manner. These findings reinforce the importance of comprehensive screening protocols and indicate that appropriate interventions, including vestibular rehabilitation, should be considered as components of clinical follow-up in this population.</div></div><div><h3>Level of Evidence</h3><div>4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101713"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year efficacy of Dupilumab in sense of smell, nasal polyp score and quality of life in CRSwNP patients: A real-world multicenter study in Brazil","authors":"Otávio Marana Mieli ,&nbsp;Fabiana Cardoso Pereira Valera ,&nbsp;Vanessa Ramos Pires Dinarte ,&nbsp;Clara Mônica Figueiredo de Lima ,&nbsp;Marcio Nakanishi ,&nbsp;Maria Eduarda Trocoli Zanetti ,&nbsp;Felipe Oliveira Pires ,&nbsp;Denny Marcos Garcia ,&nbsp;Adriana de Andrade Batista Murashima ,&nbsp;Luisa Karla de Paula Arruda ,&nbsp;Fabrizio Ricci Romano ,&nbsp;José Eduardo Seneda Lemos ,&nbsp;Eduardo Macoto Kosugi ,&nbsp;Eulalia Sakano ,&nbsp;Miguel Soares Tepedino ,&nbsp;Edwin Tamashiro ,&nbsp;Wilma Terezinha Anselmo-Lima","doi":"10.1016/j.bjorl.2025.101704","DOIUrl":"10.1016/j.bjorl.2025.101704","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic rhinosinusitis with nasal polyp (CRSwNP) is a predominant type 2 inflammatory disease, affecting the sense of smell and quality of life. Loss of smell compromises physical and emotional health, creating negative impacts and its treatment in CRSwNP is challenging.</div></div><div><h3>Aim</h3><div>To present the outcomes of dupilumab in olfactory function, Nasal Polyp Score (NPS) and quality of life in Brazilian patients with severe CRSwNP.</div></div><div><h3>Material &amp; methods</h3><div>We selected severe type 2 CRSwNP patients from different Brazilian centers. Dupilumab was indicated after failure of optimized medical and surgical treatment. Patients were evaluated with endoscopic Nasal Polyps Score (NPS), Connecticut smell test (CCCRC) and quality of life questionnaire (SNOT-22), at baseline (T0) and at one year (T1) after dupilumab was initiated. The clinical response was classified as good or non-responsive, according to the degree of improvement at T1. Regarding disease control, patients were classified as controlled, partially controlled or uncontrolled.</div></div><div><h3>Results</h3><div>53 patients completed one year of treatment (19–76 years-old); 51 individuals (96.2%) had asthma and 33 had Aspirin-Exacerbated Respiratory Disease (AERD) (62.3%). Dupilumab decreased mean SNOT-22 scores from 61.9 to 16.7 points (paired <em>t</em>-test, <em>t</em> = 13.4, p &lt; 0.0001). The median CCCRC scores improved from anosmia (0-points) to mild hyposmia (5.5-points) (Wilcoxon signed rank test, p &lt; 0.0001). Regarding NPS, we observed a decrease from a median of 6 in T0 to 1 at T1. AERD patients showed similar responses to those with only asthma as comorbid disease. Overall, most of the patients (86.8%) showed improvement in the disease control (Bowker's Test, p &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>Real-world data show that dupilumab improved NPS, smell function, and SNOT-22 scores in the Brazilian CRSwNP population. These results support the benefits of dupilumab in treating severe cases of CRSwNP.</div></div><div><h3>Level of evidence</h3><div>Level 3.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101704"},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endonasal endoscopic treatment of a rare advanced Teratocarcinosarcoma of skull base","authors":"Lucas Sousa Salgado,&nbsp;Vinicius Domene,&nbsp;Thomas Peter Maahs,&nbsp;Rafael de Castro da Silva,&nbsp;Vanessa Carvalho de Oliveira,&nbsp;Renata Papatella Araujo,&nbsp;Carlos Takahiro Chone","doi":"10.1016/j.bjorl.2025.101707","DOIUrl":"10.1016/j.bjorl.2025.101707","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101707"},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Competencies in Head and Neck Surgery teaching for medical internship. Position statement of Brazilian Head and Neck Surgery Society","authors":"Mario Augusto Ferrari de Castro ,&nbsp;Rogerio Aparecido Dedivitis ,&nbsp;Fatima Cristina Mendes de Matos ,&nbsp;Marianne Yumi Nakai ,&nbsp;Leandro Luongo de Matos ,&nbsp;Marco Aurelio Vamondes Kulcsar ,&nbsp;Flavio Carneiro Hojaij ,&nbsp;Carlos Takahiro Chone ,&nbsp;Ana Paula Souza ,&nbsp;Giovana Meira Muller","doi":"10.1016/j.bjorl.2025.101715","DOIUrl":"10.1016/j.bjorl.2025.101715","url":null,"abstract":"<div><h3>Objectives</h3><div>To standardize the necessary competencies for medical students related to Head and Neck Surgery.</div></div><div><h3>Methods</h3><div>The study was performed in 2025. The Delphi process was employed in its sequential phases: the selection of an expert panel; a structured questionnaire containing a preliminary list of potential competencies; the electronic distribution of the questionnaire to the experts, with options to “maintain”, “remove”, or “modify” the competencies and to suggest the inclusion of new competencies; a second round indicating “agree” or “disagree” for each reformulated or new competency; and the final consensus.</div></div><div><h3>Results</h3><div>Twelve competencies were established for medical students in the specialty of Head and Neck Surgery.</div></div><div><h3>Conclusion</h3><div>Undergraduate students should be directed toward the most prevalent conditions in the general practitioner's clinical practice.</div></div><div><h3>Level of evidence</h3><div>4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101715"},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of fibroblasts-derived exosomal FAP in regulating EMT in epithelial cells from chronic rhinosinusitis","authors":"Li-Fang Shen,&nbsp;Zi-Ming Fu,&nbsp;Hai-Hong Chen","doi":"10.1016/j.bjorl.2025.101703","DOIUrl":"10.1016/j.bjorl.2025.101703","url":null,"abstract":"<div><h3>Objectives</h3><div>Exosomes play a crucial role in intercellular communication and may contribute to the development of various diseases. Nevertheless, their role in Nasal Polyps (NPs) remains poorly understood. Herein, Nasal Polyp Fibroblasts (NPF) were used to release exosomes, and epithelial cells were cocultured with NPF-derived exosomes to analyze Epithelial-Mesenchymal Transition (EMT) in Chronic Rhinosinusitis (CRS).</div></div><div><h3>Methods</h3><div>We obtained exosomes from the culture media of NPFs treated with or without Fibroblast Activation Protein (FAP) inhibitor-4. Epithelial cells were coincubated with NPF-derived exosomes, and exosome internalization was analyzed by confocal microscopy. FAP and EMT markers in epithelial cells were detected by Western blotting and RT-PCR, while the migration ability of epithelial cells was detected by scratch experiments.</div></div><div><h3>Results</h3><div>NPF-derived FAP-containing exosomes were rapidly internalized by nasal epithelial cells. These exosomes induced epithelial cells to express reduced E-cadherin and increased N-cadherin and vimentin levels, while FAPI-4 could reverse these changes. Furthermore, the migration ability of epithelial cells was enhanced by FAP-carrying exosomes. Our results reveal that FAP-containing exosomes promote EMT in epithelial cells.</div></div><div><h3>Conclusion</h3><div>NPF-derived FAP-containing exosomes mediate the interaction between epithelial cells and fibroblasts and induce the EMT of epithelial cells, thereby potentially playing a crucial role in promoting remodeling in CRS. These findings suggest that FAP is a potential therapeutic target for the treatment of CRS patients.</div></div><div><h3>Level of evidence</h3><div>Level 3 ‒ Non-randomized controlled cohort/follow-up study Recommendation B.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101703"},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Green Cochlea","authors":"Abdulrahman Hagr ,&nbsp;Farid Alzhrani ,&nbsp;Fida Almuhawas ,&nbsp;Yassin Abdelsamad ,&nbsp;Medhat Yousef ,&nbsp;Asma Alahmadi ,&nbsp;Christiana Kyvelidou ,&nbsp;Ilona Anderson","doi":"10.1016/j.bjorl.2025.101718","DOIUrl":"10.1016/j.bjorl.2025.101718","url":null,"abstract":"<div><h3>Objectives</h3><div>Healthcare systems contribute significantly to global greenhouse gas emissions through energy consumption and waste generation. This study aims to explore strategies to make cochlear implantation processes more environmentally sustainable and aligned with the United Nations’ Sustainable Development Goals.</div></div><div><h3>Methods</h3><div>We examined various approaches including the use of bio-based and biodegradable materials, sustainable energy solutions, greener anesthetic practices, effective waste separation and recycling in operating rooms, and patient-centered strategies such as reducing travel and promoting early activation and fitting of cochlear implants.</div></div><div><h3>Results</h3><div>Establishing a ‘Green Team’ was identified as a key factor to raise awareness and motivation for sustainability initiatives. Implementing these strategies can significantly reduce the environmental footprint of cochlear implantation by decreasing surgical waste, lowering energy consumption, and minimizing patient-related emissions.</div></div><div><h3>Conclusion</h3><div>By adopting these sustainable practices, the cochlear implant field can reduce its environmental impact, contribute meaningfully to global sustainability efforts, and enhance patient well-being, positioning itself as a leader in healthcare sustainability.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101718"},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}