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The emerging role of anti-thymic stromal lymphopoietin monoclonal antibody (Tezepelumab) in comorbid and non-comorbid CRSwNP patients: a scoping review 抗胸腺基质淋巴生成素单克隆抗体(Tezepelumab)在合并症和非合并症CRSwNP患者中的新作用:范围综述
IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2026-01-17 DOI: 10.1016/j.bjorl.2026.101768
Antonio Moffa , Eugenio de Corso , Domiziana Nardelli , Antonella Loperfido , Jacopo Galli , Peter Baptista , Manuele Casale

Objective

This systematic review aims to evaluate the effectiveness of Tezepelumab, a monoclonal antibody targeting the thymic stromal lymphopoietin, in patients affected by chronic rhinosinusitis with nasal polyposis, both with and without comorbid asthma.

Methods

A systematic search of the literature was conducted across PubMed, SCOPUS, and Google Scholar databases until April 2025. Studies were selected based on predefined inclusion criteria, focusing on adult patients with clinically diagnosed chronic rhinosinusitis with nasal polyps who received Tezepelumab treatment for at least four weeks and reported validated clinical outcomes. Studies involving patients receiving prior standard treatment and comorbid asthma were included. Outcome measures included sinonasal symptom scores, imaging scores, pulmonary function tests, quality of life assessments, systemic corticosteroid use, and the need for surgical intervention. Study selection, data extraction, and quality assessment were conducted independently by two reviewers.

Result

Out of 221 screened records, three randomized controlled trials involving a total of 691 patients met the eligibility criteria. Tezepelumab treatment resulted in significant improvements in nasal symptom scores, including reductions in nasal congestion and loss of smell, as well as improved quality of life and sleep-related symptoms. Objective assessments showed a reduction in polyp size and radiological scores, with fewer patients requiring systemic corticosteroids or surgical intervention compared to placebo. Improvements were also observed in lung function and disease control among patients with comorbid asthma. The effect size exceeded minimal clinically important difference thresholds across key outcome measures.

Conclusion

Tezepelumab demonstrated consistent and clinically meaningful benefits in the treatment of chronic rhinosinusitis with nasal polyps, including symptom relief, reduced polyp burden, and decreased need for corticosteroids or surgery. Its upstream mechanism offers potential advantages over existing biologic therapies. Further long-term and real-world studies are needed to confirm its role in clinical practice and define ideal patient selection strategies.
目的:本系统综述旨在评估Tezepelumab(一种靶向胸腺基质淋巴生成素的单克隆抗体)在慢性鼻窦炎合并鼻息肉病(伴或不伴哮喘)患者中的有效性。方法:系统检索PubMed、SCOPUS和谷歌Scholar数据库的文献,直至2025年4月。研究是根据预定义的纳入标准选择的,重点是临床诊断为慢性鼻窦炎合并鼻息肉的成年患者,这些患者接受Tezepelumab治疗至少四周,并报告了经过验证的临床结果。研究纳入了既往接受标准治疗和共病哮喘的患者。结果测量包括鼻窦症状评分、影像学评分、肺功能检查、生活质量评估、全身皮质类固醇使用和手术干预的需要。研究选择、数据提取和质量评估由两位审稿人独立进行。结果:在221个筛选记录中,有3个随机对照试验共涉及691例患者符合入选标准。Tezepelumab治疗导致鼻症状评分显著改善,包括鼻塞和嗅觉丧失的减少,以及生活质量和睡眠相关症状的改善。客观评估显示,与安慰剂相比,息肉大小和放射学评分减少,需要全身皮质类固醇或手术干预的患者减少。合并哮喘患者的肺功能和疾病控制也有改善。在关键结果测量中,效应值超过了最小的临床重要差异阈值。结论:Tezepelumab在治疗慢性鼻窦炎伴鼻息肉方面表现出一致且具有临床意义的益处,包括症状缓解、减轻息肉负担、减少对皮质类固醇或手术的需求。它的上游机制比现有的生物疗法具有潜在的优势。需要进一步的长期和现实世界的研究来证实其在临床实践中的作用,并确定理想的患者选择策略。
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引用次数: 0
Brazilian Academy of Paediatric Otorhinolaryngology Task Force – lingual frenulum disorders in childhood – evidence-based recommendations 巴西儿科科学院耳鼻喉科工作组-儿童舌系带疾病-循证建议。
IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2026-01-17 DOI: 10.1016/j.bjorl.2026.101762
Juliana Alves de Sousa Caixeta , Debora Bressan Pazinatto , Rita Carolina Pozzer Krumenauer Padoin , José Faibes Lubianca Neto , Melissa Ameloti Gomes Avelino , Vitor Guo Chen , Trissia Maria Farah Vazzoler , Leticia Teixeira Castellano , Sulene Pirana , Carolina Sponchiado Miura , Edio Júnior Cavallaro Magalhães , Rodrigo Guimarães Pereira

Objective

To provide evidence-based recommendations for the diagnosis, assessment of functional impact, and management of altered lingual frenulum in children.

Methods

Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on ankyloglossia, or lingual frenotomy were eligible for inclusion. The American College of Physicians’ guideline grading system was used for critical appraisal of evidence and recommendations for therapeutic interventions.

Results

There are several methods described in the literature for the evaluation of the lingual frenulum, and most of them lack internal or external validation. There are no data supporting a relationship between altered lingual frenulum and dysphagia, orofacial alterations, malocclusion, social limitations, obstructive sleep apnoea, or gastroesophageal reflux. According to the studies, an altered lingual frenulum does not cause speech delay; however, some studies with very low levels of evidence show that an altered lingual frenulum may make the pronunciation of some phonemes more difficult. In children with an altered lingual frenulum, lingual frenotomy may reduce maternal pain during breastfeeding. Therefore, in children with an altered lingual frenulum, lingual frenotomy may be a good therapeutic option when there is a complaint of pain during breastfeeding. There are several surgical techniques described in the literature for the release of the lingual frenulum, as well as different instruments that can be used for this purpose. There is no scientific evidence that one method is superior to another.

Conclusion

Lingual frenectomy may improve maternal pain during breastfeeding and may be an option in selected cases of phonetic alterations.
目的:为儿童舌系带改变的诊断、功能影响评估和治疗提供循证建议。方法:对工作组成员进行知识综合方法的培训,包括电子数据库检索、相关引文的审查和选择,以及对选定的研究进行批判性评价。用英语或葡萄牙语写的关于强直性咬合或舌骨切开术的文章符合入选条件。美国医师学会指南分级系统用于对治疗干预措施的证据和建议进行批判性评估。结果:文献中有几种评价舌系带的方法,但大多缺乏内部或外部验证。没有数据支持舌系带改变与吞咽困难、口面部改变、错颌、社交限制、阻塞性睡眠呼吸暂停或胃食管反流之间的关系。根据研究,舌系带改变不会导致语言延迟;然而,一些证据水平非常低的研究表明,舌系带的改变可能会使某些音素的发音更加困难。舌系带改变的儿童,舌系带切开术可以减少母乳喂养期间母亲的疼痛。因此,对于舌系带改变的儿童,舌系带切开术可能是一个很好的治疗选择,当母乳喂养期间有疼痛的投诉。文献中描述了几种用于舌系带松解的手术技术,以及可用于此目的的不同器械。没有科学证据表明一种方法优于另一种方法。结论:舌系带切除术可以改善母亲在母乳喂养期间的疼痛,可能是一种选择,在选定的情况下语音改变。
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引用次数: 0
How to teach otologic surgery to the next generation? 如何向下一代传授耳外科知识?
IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2026-01-17 DOI: 10.1016/j.bjorl.2025.101749
Amanda Sampaio Almeida, José Ricardo Gurgel Testa
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引用次数: 0
Simultaneous intraparotid and intratemporal facial nerve schwannoma: resection of the lesion and nerve reconstruction with cross-face technique ‒ Case report 同时发生的腮腺和颞内面神经鞘瘤:病变切除和交叉面技术重建神经- 1例报告。
IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2026-01-17 DOI: 10.1016/j.bjorl.2026.101761
José Fernando Polanski , Anelyse Pulner Agulham , Beatriz Alvarez Mattar , Anne Karoline Groth , Marja Cristiane Reksidler
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引用次数: 0
Discriminative validity and diagnostic accuracy of Horus® posturographic parameters in individuals with and without vestibulopathy Horus®姿势参数在患有和不患有前庭神经病变的个体中的判别有效性和诊断准确性
IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2026-01-09 DOI: 10.1016/j.bjorl.2025.101746
Maria Clara Peixoto Marinheiro , Ana Clara Teixeira Fernandes , Luana Dantas da Silva , Adriana Guedes Carlos , José Diniz Júnior , Juliana Maria Gazzola , Vanessa Regiane Resqueti

Objective

To assess the discriminative validity and diagnostic accuracy of posturographic parameters from the Horus® in individuals with and without vestibulopathy.

Methods

This is a methodological study of discriminative validity and diagnostic accuracy. 153 individuals aged 40–79, of both sexes, were included and divided into Group 1 (with vestibular dysfunction) and Group 2 (without vestibular dysfunction). Instruments on clinical characterization, cognition, physical activity level, and posturography were applied. Discriminative validity was assessed with nonparametric multivariate analyses, the Mann-Whitney test, controlled with Holm adjustment and rank-biserial correlation to estimate effect size. Sensitivity, specificity, area under the curve, and cutoff points were calculated using ROC curves.

Results

The final sample included 78 individuals in Group 1 and 75 in Group 2, with mean ages of 59.36 and 56.48 years, respectively. Significant differences were found between the groups for all dependent variables related to confidence ellipse/limit of stability and mediolateral velocity (p < 0.001), with moderate to large differences (ES > 0.28) and in most of the anteroposterior velocity and sensory analysis (p < 0.005), with small to moderate differences (ES: >0.11 and <0.43). The ROC curve analysis revealed that confidence ellipse/limit of stability and mediolateral velocity exhibited high specificity (84% and 80%) and moderate sensitivity (52.6% and 53.85%). The Vestibular Function parameter demonstrated good sensitivity (70%) and moderate specificity (60.8%), while the Composite Balance Index showed a sensitivity of 79.5% and specificity of 64%.

Conclusion

Horus® posturographic parameters demonstrated moderate to good discriminative ability to differentiate individuals with and without vestibular dysfunction, with high sensitivity for vestibular function and the Composite Balance Index.

Level of evidence

3 (cross-sectional study).
目的评价Horus®姿势测量参数对有或无前庭神经病变患者的鉴别有效性和诊断准确性。方法对鉴别效度和诊断准确性进行方法学研究。153名年龄在40-79岁之间的男性和女性被纳入研究,并被分为1组(有前庭功能障碍)和2组(没有前庭功能障碍)。应用临床特征、认知、身体活动水平和体位测量仪器。判别效度评估采用非参数多变量分析、Mann-Whitney检验,控制采用Holm调整和秩-双列相关来估计效应量。采用ROC曲线计算灵敏度、特异度、曲线下面积和截止点。结果1组78例,2组75例,平均年龄分别为59.36岁和56.48岁。在与置信椭圆/稳定性极限和中外侧速度相关的所有因变量(p < 0.001)中,有中等到较大的差异(ES > 0.28),在大多数前后速度和感觉分析中(p < 0.005),有小到中等的差异(ES: >;0.11和<;0.43),组间存在显著差异。ROC曲线分析显示,稳定性和中外侧速度的置信椭圆/极限具有高特异性(84%和80%)和中等敏感性(52.6%和53.85%)。前庭功能指标具有良好的敏感性(70%)和中等的特异性(60.8%),而综合平衡指数的敏感性为79.5%,特异性为64%。结论horus®姿势测量参数对前庭功能和综合平衡指数具有较高的敏感性,对前庭功能和非前庭功能障碍具有中等至良好的区分能力。证据水平3(横断面研究)。
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引用次数: 0
An affordable and optimized 3D biomodel for sinonasal surgery training 一个负担得起的和优化的三维生物模型的鼻窦外科训练
IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2026-01-08 DOI: 10.1016/j.bjorl.2025.101750
Marcelo Augusto Antonio , Sergio Lopes Fernandes Ramos , Fernando Augusto Lima Marson , Mariana Dalbo Contrera Toro , Eulalia Sakano

Objectives

To develop and evaluate the anatomical accuracy and haptic fidelity of an affordable kit consisting of a silicone head, a foam support, and a 3D-printed biomodel of the paranasal sinuses for surgical training.

Methods

This single-center, technological, and interventional study detailed the development of a human sinus biomodel. Its anatomical and haptic evaluation was conducted by ten senior rhinologists, who performed 37 standard surgical tasks. Participants rated similarity to fresh cadaveric dissection on a 5-point Likert scale. Computed tomographic images were converted into a standard tessellation file through a combination of automatic and manual segmentation. This file was then used in a 3D printer to create the biomodel, which was customized with a red silicone coating to emulate mucosa, as well as silicone-insulated wire and acrylic yarn to simulate arteries and nerves. The model was mounted onto a silicone head and foam support, with a total production cost of US$ 43.37.

Results

The similarity of anatomic landmarks scored a mean above 4.0 ± SD on both sides. The lacrimal bone drilling/debulking procedure was somewhat suboptimal for exposing the lacrimal sac, scoring a mean of 3.1 ± 1.04 on the left side but 4.3 ± 0.64 on the right. Likewise, uncinectomy was rated 3.4 ± 1.02 on the left and 3.7 ± 0.90 on the right, while the periorbit incision received scores of 3.5 ± 0.92 on the left and 4.5 ± 0.50 on the right. All other steps received ratings above 4.0 ± SD.

Conclusion

This study presents a fully reproducible and cost-effective method for constructing a 3D sinus biomodel. The model demonstrated high anatomical and haptic fidelity, as validated by senior rhinologists, making it a valuable tool for surgical training in sinonasal procedures.

Level of evidence

This study provides Level 2 evidence.
目的开发和评估一种由硅胶头、泡沫支架和3d打印鼻窦生物模型组成的经济实惠的套件,用于外科训练。方法本研究采用单中心、技术和介入性方法,详细介绍了人类鼻窦生物模型的建立。其解剖和触觉评估由10名高级鼻医师进行,他们执行了37项标准手术任务。参与者用5分李克特量表评定与新鲜尸体解剖的相似性。通过自动分割和人工分割相结合的方法,将计算机层析图像转换为标准的镶嵌文件。然后将该文件用于3D打印机来创建生物模型,该生物模型使用红色硅胶涂层来模拟粘膜,以及硅胶绝缘线和丙烯酸纱线来模拟动脉和神经。该模型安装在硅胶头和泡沫支架上,总生产成本为43.37美元。结果两组解剖标志相似度均在4.0±SD以上。泪骨钻孔/减体积术在暴露泪囊方面不太理想,左侧平均得分为3.1±1.04,右侧平均得分为4.3±0.64。同样,眼眶切除术左侧评分为3.4±1.02分,右侧评分为3.7±0.90分,眼眶周围切口左侧评分为3.5±0.92分,右侧评分为4.5±0.50分。其他步骤评分均在4.0±SD以上。结论本研究为构建三维鼻窦生物模型提供了一种完全可重复性和成本效益高的方法。该模型具有较高的解剖学和触觉保真度,经高级鼻医师验证,使其成为鼻鼻部手术训练的宝贵工具。证据等级本研究提供2级证据。
{"title":"An affordable and optimized 3D biomodel for sinonasal surgery training","authors":"Marcelo Augusto Antonio ,&nbsp;Sergio Lopes Fernandes Ramos ,&nbsp;Fernando Augusto Lima Marson ,&nbsp;Mariana Dalbo Contrera Toro ,&nbsp;Eulalia Sakano","doi":"10.1016/j.bjorl.2025.101750","DOIUrl":"10.1016/j.bjorl.2025.101750","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop and evaluate the anatomical accuracy and haptic fidelity of an affordable kit consisting of a silicone head, a foam support, and a 3D-printed biomodel of the paranasal sinuses for surgical training.</div></div><div><h3>Methods</h3><div>This single-center, technological, and interventional study detailed the development of a human sinus biomodel. Its anatomical and haptic evaluation was conducted by ten senior rhinologists, who performed 37 standard surgical tasks. Participants rated similarity to fresh cadaveric dissection on a 5-point Likert scale. Computed tomographic images were converted into a standard tessellation file through a combination of automatic and manual segmentation. This file was then used in a 3D printer to create the biomodel, which was customized with a red silicone coating to emulate mucosa, as well as silicone-insulated wire and acrylic yarn to simulate arteries and nerves. The model was mounted onto a silicone head and foam support, with a total production cost of US$ 43.37.</div></div><div><h3>Results</h3><div>The similarity of anatomic landmarks scored a mean above 4.0 ± SD on both sides. The lacrimal bone drilling/debulking procedure was somewhat suboptimal for exposing the lacrimal sac, scoring a mean of 3.1 ± 1.04 on the left side but 4.3 ± 0.64 on the right. Likewise, uncinectomy was rated 3.4 ± 1.02 on the left and 3.7 ± 0.90 on the right, while the periorbit incision received scores of 3.5 ± 0.92 on the left and 4.5 ± 0.50 on the right. All other steps received ratings above 4.0 ± SD.</div></div><div><h3>Conclusion</h3><div>This study presents a fully reproducible and cost-effective method for constructing a 3D sinus biomodel. The model demonstrated high anatomical and haptic fidelity, as validated by senior rhinologists, making it a valuable tool for surgical training in sinonasal procedures.</div></div><div><h3>Level of evidence</h3><div>This study provides Level 2 evidence.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 2","pages":"Article 101750"},"PeriodicalIF":1.8,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925366","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}
引用次数: 0
Association of triglyceride and cholesterol with vestibular vertigo: Evidence from univariable and multivariable mendelian randomization and mediation analysis 甘油三酯和胆固醇与前庭性眩晕的关系:来自单变量和多变量孟德尔随机化和中介分析的证据
IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2026-01-07 DOI: 10.1016/j.bjorl.2025.101747
Ying Mu , Yacheng Lu , Wei Fu

Objectives

This study aimed to use Mendelian Randomization (MR) method to explore the potential causal association of triglyceride and cholesterol on the risk of vestibular vertigo and potential mediating factors.

Methods

We extracted genetic variants associated with triglyceride and cholesterol from the genome-wide association study. Univariable two-sample MR were performed to evaluate the effects of triglyceride and cholesterol on the vestibular vertigo. Besides, Multivariate MR (MVMR) was used to estimate direct effects of triglyceride and cholesterol on the vestibular vertigo after adjusting for potential mediating factors. We also performed that a two-step mediation MR framework to elucidate potential mediators and to estimate the proportion of the association mediated.

Results

Genetically predicted triglyceride and cholesterol were positively associated with the risk of vestibular vertigo. In the MVMR analysis, causal associations between triglyceride and cholesterol with vestibular vertigo remained stable and robust after adjusting for body mass index, hypertension, and type 2 diabetes, whereas the association between triglyceride and cholesterol and the risk of vestibular vertigo became nonsignificant after adjusting for vitamin D. In the mediation analysis, we found that the causal effect of cholesterol on vestibular vertigo might partly mediated by vitamin D.

Conclusion

The present study provides robust evidence that genetically predicted triglyceride and cholesterol are independently causally associated with the risk of vestibular vertigo. Vitamin D also was found to mediate the causal pathways between cholesterol and vestibular vertigo.

Level of evidence

Level III.
目的采用孟德尔随机化方法,探讨甘油三酯和胆固醇与前庭性眩晕发病风险的潜在因果关系及可能的中介因素。方法从全基因组关联研究中提取与甘油三酯和胆固醇相关的遗传变异。单变量双样本磁共振评估甘油三酯和胆固醇对前庭性眩晕的影响。此外,多变量磁共振(MVMR)用于评估甘油三酯和胆固醇对前庭性眩晕的直接影响,调整了潜在的中介因素。我们还执行了两步中介MR框架,以阐明潜在的中介并估计关联中介的比例。结果基因预测的甘油三酯和胆固醇与前庭性眩晕的风险呈正相关。在MVMR分析中,在调整了体重指数、高血压和2型糖尿病因素后,甘油三酯和胆固醇与前庭性眩晕之间的因果关系保持稳定和强烈,而在调整了维生素d因素后,甘油三酯和胆固醇与前庭性眩晕风险之间的关系变得不显著。我们发现胆固醇对前庭性眩晕的因果影响可能部分由维生素d介导。结论本研究提供了强有力的证据,证明遗传预测的甘油三酯和胆固醇与前庭性眩晕的风险独立因果相关。维生素D也被发现可以调节胆固醇和前庭性眩晕之间的因果关系。证据等级:III级。
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引用次数: 0
Image-guided protocol with a guide-marker for bone conduction hearing implant placement estimation 带引导标记的骨传导听力植入物位置估计的图像引导方案
IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2026-01-07 DOI: 10.1016/j.bjorl.2025.101748
Renata Tadeu Ramirez Garcia , Antonio Carlos dos Santos , Fabiana Danieli-Hyppolito , Miguel Angelo Hyppolito

Objective

To propose a protocol for image-guided implant placement estimation, combining 3D reconstruction of preoperative Computed Tomography (CT) images and a guide-marker, for individuals undergoing percutaneous Bone Conduction Hearing Devices (BCHD).

Methods

Fifty-one subjects aged 6- to 75-years undergoing percutaneous BCHD surgery were included. Three optional implant points were estimated and marked using a guide-marker, and compared with preoperative CT images to define optimal placement. A peer validation was conducted by two independent reviewers to assess the replicability of the protocol in clinical practice.

Results

Bilateral CT images were obtained from all 51 subjects, and a total of 54 BCHD surgeries were performed. Relevant findings, including mastoid cells (19.6%), cranial suture lines (27.5%), perforating vessels (13.7%), bone surface irregularities (1.9%), venous lakes (9.8%), and fixation plates (3.9%) were identified in 52.9% of subjects, and they affected the implant placement in 37.3% of cases. There was moderate agreement between the reviewers regarding implant placement in both right and left ears, and in relation to the actual implant placement performed during the surgical procedure.

Conclusion

The image-guided implant placement estimation, combining 3D reconstruction of preoperative Computed Tomography (CT) images and a guide-marker, has proven reliable and effective for estimating optimal implant placement in subjects undergoing percutaneous BCHD surgery, thereby constituting a valuable tool for clinical practice.

Level of evidence

2.
目的针对经皮骨传导助听器(BCHD)患者,提出一种结合术前计算机断层扫描(CT)图像三维重建和引导标记的图像引导植入物位置估计方案。方法选取51例6 ~ 75岁经皮BCHD手术患者。使用引导标记估计和标记三个可选的植入点,并与术前CT图像进行比较以确定最佳放置位置。同行验证由两名独立审稿人进行,以评估该方案在临床实践中的可重复性。结果51例患者均获得双侧CT图像,共行54例BCHD手术。52.9%的受试者发现乳突细胞(19.6%)、颅骨缝合线(27.5%)、穿孔血管(13.7%)、骨表面不规则(1.9%)、静脉湖(9.8%)和固定板(3.9%)等相关发现,影响种植体放置的病例占37.3%。对于右耳和左耳的种植体放置,以及在手术过程中实际进行的种植体放置,审稿人之间有中等程度的一致。结论结合术前CT图像的三维重建和引导标记,图像引导下的种植体放置估计可靠有效,可用于经皮BCHD手术患者的最佳种植体放置估计,为临床实践提供了有价值的工具。证据水平2。
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引用次数: 0
Nomogram for predicting cognitive impairment in middle-aged and elderly individuals with self-reported hearing loss: Insights from the longitudinal CHARLS cohort 预测自我报告听力损失的中老年个体认知障碍的Nomogram:来自纵向CHARLS队列的见解
IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2026-01-07 DOI: 10.1016/j.bjorl.2025.101751
Cheng Li , Yan Mei , Wei Li , Dan Liu

Objective

To develop and evaluate a predictive model for cognitive impairment, assessed by a brief cognitive test, among middle-aged and older adults with self-reported hearing loss, aiming to facilitate early identification and targeted intervention in high-risk populations.

Methods

This study utilized data from the 2011–2018 waves of the China Health and Retirement Longitudinal Study, including 1,093 individuals aged 45 and above with self-reported hearing impairment but normal cognition at baseline. The average follow-up duration was 5.2-years. Cognitive impairment was defined as a total cognitive score at least one standard deviation below the mean for the corresponding age group. Univariate and multivariate Cox proportional hazards models were used to identify independent predictors, and a nomogram was constructed based on significant variables. Model performance was assessed using calibration curves, time-dependent Concordance indices (C-index), and the Area Under the receiver operating Characteristic Curve (AUC). Risk stratification analysis was conducted across various sociodemographic subgroups.

Results

During follow-up, 152 individuals (13.9%) developed cognitive impairment. Higher education level, urban residence, and participation in leisure social activities (e.g., playing mahjong) were independently associated with lower risk of cognitive impairment. The nomogram demonstrated good discriminative performance, with AUCs of 0.728, 0.762, and 0.768, and corresponding time-dependent C-indices of 0.719, 0.761, and 0.767 at 3-, 5-, and 6-year follow-up points, respectively. Calibration plots indicated good agreement between predicted and observed risks. Risk scores varied significantly across subgroups defined by sex, age, education level, and residential location. Kaplan–Meier analyses confirmed the model’s effective risk stratification capability.

Conclusion

This study presents the first predictive model tailored to cognitive risk heterogeneity among older adults with self-reported hearing loss. By incorporating a brief cognitive test, the nomogram demonstrated reliable performance and holds potential for use in risk stratification, population screening, and personalized preventive interventions.

Level of evidence

2 ‒ Prospective cohort study based on the longitudinal CHARLS data.
目的建立和评估一种自我报告听力损失的中老年认知障碍预测模型,通过简短的认知测试来评估,旨在促进对高危人群的早期识别和有针对性的干预。方法本研究利用2011-2018年中国健康与退休纵向研究的数据,包括1093名45岁及以上、自述听力障碍但基线认知正常的个体。平均随访时间为5.2年。认知障碍被定义为总认知评分低于相应年龄组的平均值至少一个标准差。采用单因素和多因素Cox比例风险模型识别独立预测因子,并根据显著变量构建nomogram。使用校准曲线、随时间变化的一致性指数(C-index)和接收器工作特征曲线下面积(AUC)来评估模型的性能。在不同的社会人口亚组中进行了风险分层分析。结果随访期间,152例(13.9%)出现认知障碍。高等教育水平、城市居住和参与休闲社会活动(如打麻将)与认知障碍风险较低独立相关。nomogram表现出良好的判别性,auc分别为0.728、0.762和0.768,相应的时间相关c指数分别为0.719、0.761和0.767,分别为随访3年、5年和6年。校正图显示预测风险与观测风险之间的一致性很好。风险评分在按性别、年龄、教育水平和居住地点定义的亚组之间差异显著。Kaplan-Meier分析证实了该模型的有效风险分层能力。本研究提出了首个针对自我报告听力损失的老年人认知风险异质性的预测模型。通过结合一个简短的认知测试,nomogram显示出可靠的性能,并在风险分层、人群筛查和个性化预防干预方面具有潜在的应用潜力。证据水平2 -基于纵向CHARLS数据的前瞻性队列研究。
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引用次数: 0
Association between hepatitis B and C viruses and head and neck lymphoma: A case-control study 乙型和丙型肝炎病毒与头颈部淋巴瘤的关系:一项病例对照研究
IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2026-01-01 DOI: 10.1016/j.bjorl.2025.101701
Wan-Hsun Tsai , Ching-Chih Lee , Ting-Shou Chang

Objective

This study aims to assess the relationship between Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections and Head and Neck (H&N) lymphoma in a region where HBV and HCV are highly prevalent.

Methods

Patients diagnosed with H&N lymphoma between 2013 and 2022 at our institution were eligible for the study, with exclusion criteria applied to patients with a history of recurrence, other cancers, HIV infections, organ transplantation, and those below 18-years of age. The first and the second control group comprised outpatients and patients diagnosed with Head and Neck Squamous Cell Carcinoma (HNSCC) who were gender and age-matched at the same hospital. Logistic regression analysis, which was adjusted for sex, age, smoking, alcohol consumption, Rheumatoid Arthritis (RA), and Systemic Lupus Erythematosus (SLE), was utilized to estimate the Odds Ratio (OR) and 95% Confidence Interval (95% CI) for HBV and HCV infection status.

Results

From 2013 to 2022, 304 patients with H&N lymphoma were identified. After excluding those with a history of other cancers or recurrences, 262 patients remained. The first control group included 1048 matched outpatients. Additionally, 262 patients diagnosed with HNSCC during the same period were selected as the second control group. Of the 242 Non-Hodgkin Lymphoma (NHL) patients, 102 had Extranodal Lymphoma (ENL). Of these ENL patients, 49 tested positive for HBV and 17 for HCV. After controlling for the confounding factors, NHL patients with HBsAg positivity had a significantly higher prevalence rate than healthy controls, particularly among B-cell Lymphoma and Diffuse Large B-Cell Lymphoma (DLBCL) patients. Furthermore, there were no significant differences in HCV infections between the three groups.

Conclusions

In conclusion, the study found a significant link between HBV infection and H&N NHL, particularly DLBCL in Taiwan. However, no significant link was discovered between HCV infection and H&N lymphoma. These findings suggest a potential role for HBV in the development of H&N NHL and DLBCL.

Level of evidence

4.
目的:本研究旨在评估乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)感染与头颈部淋巴瘤(H&N)在HBV和HCV高度流行地区的关系。方法:选取我院2013 - 2022年诊断为H&N淋巴瘤的患者为研究对象,排除标准为有复发史、其他癌症史、HIV感染史、器官移植史、18岁以下患者。第一组和第二组对照组由同一家医院的门诊患者和诊断为头颈部鳞状细胞癌(HNSCC)的患者组成,他们的性别和年龄相匹配。采用Logistic回归分析,对性别、年龄、吸烟、饮酒、类风湿关节炎(RA)和系统性红斑狼疮(SLE)进行校正,估计HBV和HCV感染状态的优势比(OR)和95%置信区间(95% CI)。结果:2013 - 2022年共发现H&N淋巴瘤304例。在排除有其他癌症病史或复发的患者后,剩下262名患者。第一个对照组包括1048名匹配的门诊患者。另外,选取同期诊断为HNSCC的262例患者作为第二对照组。在242例非霍奇金淋巴瘤(NHL)患者中,102例为结外淋巴瘤(ENL)。在这些ENL患者中,49例HBV检测呈阳性,17例HCV检测呈阳性。在控制混杂因素后,HBsAg阳性的NHL患者的患病率明显高于健康对照组,特别是在b细胞淋巴瘤和弥漫大b细胞淋巴瘤(DLBCL)患者中。此外,三组之间的HCV感染没有显著差异。结论:总之,研究发现HBV感染与H&N NHL之间存在显著联系,特别是在台湾的DLBCL。然而,HCV感染与H&N淋巴瘤之间没有明显的联系。这些发现提示HBV在H&N NHL和DLBCL发展中的潜在作用。证据等级:4;
{"title":"Association between hepatitis B and C viruses and head and neck lymphoma: A case-control study","authors":"Wan-Hsun Tsai ,&nbsp;Ching-Chih Lee ,&nbsp;Ting-Shou Chang","doi":"10.1016/j.bjorl.2025.101701","DOIUrl":"10.1016/j.bjorl.2025.101701","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to assess the relationship between Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections and Head and Neck (H&amp;N) lymphoma in a region where HBV and HCV are highly prevalent.</div></div><div><h3>Methods</h3><div>Patients diagnosed with H&amp;N lymphoma between 2013 and 2022 at our institution were eligible for the study, with exclusion criteria applied to patients with a history of recurrence, other cancers, HIV infections, organ transplantation, and those below 18-years of age. The first and the second control group comprised outpatients and patients diagnosed with Head and Neck Squamous Cell Carcinoma (HNSCC) who were gender and age-matched at the same hospital. Logistic regression analysis, which was adjusted for sex, age, smoking, alcohol consumption, Rheumatoid Arthritis (RA), and Systemic Lupus Erythematosus (SLE), was utilized to estimate the Odds Ratio (OR) and 95% Confidence Interval (95% CI) for HBV and HCV infection status.</div></div><div><h3>Results</h3><div>From 2013 to 2022, 304 patients with H&amp;N lymphoma were identified. After excluding those with a history of other cancers or recurrences, 262 patients remained. The first control group included 1048 matched outpatients. Additionally, 262 patients diagnosed with HNSCC during the same period were selected as the second control group. Of the 242 Non-Hodgkin Lymphoma (NHL) patients, 102 had Extranodal Lymphoma (ENL). Of these ENL patients, 49 tested positive for HBV and 17 for HCV. After controlling for the confounding factors, NHL patients with HBsAg positivity had a significantly higher prevalence rate than healthy controls, particularly among B-cell Lymphoma and Diffuse Large B-Cell Lymphoma (DLBCL) patients. Furthermore, there were no significant differences in HCV infections between the three groups.</div></div><div><h3>Conclusions</h3><div>In conclusion, the study found a significant link between HBV infection and H&amp;N NHL, particularly DLBCL in Taiwan. However, no significant link was discovered between HCV infection and H&amp;N lymphoma. These findings suggest a potential role for HBV in the development of H&amp;N NHL and DLBCL.</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 101701"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259718","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}
引用次数: 0
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Brazilian Journal of Otorhinolaryngology
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