Brazilian Journal of Otorhinolaryngology最新文献

{"title":"Effectiveness of hypertonic saline irrigation following functional endoscopic sinus surgery: a systematic review and meta-analysis","authors":"Adriano Damasceno Lima ,&nbsp;Rodolfo Baptista Giffoni ,&nbsp;Julieta Arguelles-Hernandez ,&nbsp;Gabriele Santos ,&nbsp;Victor L.J.C. Sena ,&nbsp;Ricardo S. Aguiar ,&nbsp;Marcelo L.S. Cruz ,&nbsp;Maria E.P. Dalmaschio ,&nbsp;Marcio Nakanishi","doi":"10.1016/j.bjorl.2024.101517","DOIUrl":"10.1016/j.bjorl.2024.101517","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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; <em>p</em> = 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; <em>p</em> = 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; <em>p</em> &lt; 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; <em>p</em> &lt; 0.00001; I² = 0%) and a SNOT 20/22 Standard Mean Difference (SMD) (SMD = −1.65; 95% CI −2.7 to −0.61; <em>p</em> = 0.002; I² = 93%) reduction from baseline in 30–45 days after the surgery.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101517"},"PeriodicalIF":1.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587186","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}

{"title":"Impact of hearing impairment on cognitive performance","authors":"Pedro Ivo Machado Pires de Araújo ,&nbsp;Pauliana Lamounier e Silva Duarte ,&nbsp;Hugo Valter Lisboa Ramos ,&nbsp;Claudiney Cândido Costa ,&nbsp;Isabela Gomes Maldi ,&nbsp;Lucas da Silva Braz ,&nbsp;Norma de Oliveira Penido","doi":"10.1016/j.bjorl.2024.101521","DOIUrl":"10.1016/j.bjorl.2024.101521","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Level of evidence</h3><div>Level 4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 2","pages":"Article 101521"},"PeriodicalIF":1.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591851","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}

{"title":"Perineural invasion and laryngeal squamous cell carcinoma: a systematic review","authors":"Debora Modelli Vianna Ocampo Quintana ,&nbsp;Rogerio Aparecido Dedivitis ,&nbsp;Luiz Paulo Kowalski","doi":"10.1016/j.bjorl.2024.101519","DOIUrl":"10.1016/j.bjorl.2024.101519","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>A literature review was performed, searching MedLine via PubMed, Scielo, Lilacs, Cochrane and Websco. RevMan 5.4 was used for the statistical analysis.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>IPN is a negative prognostic factor in laryngeal cancer.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101519"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565192","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}

{"title":"Robotic-assisted cochlear implant surgery","authors":"Vagner Antonio Rodrigues Silva,&nbsp;Arthur Menino Castilho","doi":"10.1016/j.bjorl.2024.101530","DOIUrl":"10.1016/j.bjorl.2024.101530","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"90 6","pages":"Article 101530"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579099","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}

{"title":"Enlarged vestibular aqueduct with bilateral sensorineural hearing loss following cranial trauma: a case report","authors":"Alexandre Camilotti Gasperin ,&nbsp;Bruna Timm Monteiro ,&nbsp;Ellen Paula Schetz Zawierucha ,&nbsp;Enrico Guido Oliveira Minniti ,&nbsp;Matheus Roberto Schetz Alves ,&nbsp;Pedro Henrique Vicari Passos","doi":"10.1016/j.bjorl.2024.101518","DOIUrl":"10.1016/j.bjorl.2024.101518","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101518"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552287","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}

{"title":"Pre-clinical training, technical adjustment and human case experience of transoral robotic surgery using Versius System","authors":"Guilherme Reimann Agne ,&nbsp;Gustavo Nunes Bento ,&nbsp;Marcelo Belli ,&nbsp;Gustavo Becker Pereira ,&nbsp;Renan Bezerra Lira ,&nbsp;Leandro Luongo Matos ,&nbsp;Luiz Paulo Kowalski","doi":"10.1016/j.bjorl.2024.101515","DOIUrl":"10.1016/j.bjorl.2024.101515","url":null,"abstract":"<div><h3>Objective</h3><div>This study describes the training experience with the Versius Robotic System (CMR Surgical) for Transoral Robotic Surgery (TORS), the setup of the robot and its applicability in a human case.</div></div><div><h3>Methods</h3><div>A model mannequin with anatomical characteristics simulating the TORS working space was used for training purposes. Optimal docking, positioning of robotic arms and placement of instruments were defined using the mannequin. A human patient was selected based on the inclusion criteria, and a standardized protocol for robotic techniques was developed. The surgical procedure was conducted in accordance with ethical guidelines.</div></div><div><h3>Results</h3><div>The synthetic polymer mannequin mimicking human tissues and anatomy was used to define the robot set up for TORS. The patient was indicated for bilateral tonsillectomy due to recurrent episodes of tonsillitis. Bipolar Maryland and monopolar scissors were used. The procedure was uneventful. The patient remained hospitalized for 1 day and returned to work activities within 6-days, with no complications.</div></div><div><h3>Conclusion</h3><div>The specialized mannequin proved to be effective in the simulation, training proposal and set up standardization. Furthermore, the Versius robot was found to be safe and achieved excellent results during surgery. Despite being very promising, the Versius system is still in its developmental phase and requires larger-scale samples for a more comprehensive evaluation.</div></div><div><h3>Level of evidence</h3><div>4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101515"},"PeriodicalIF":1.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606927","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}

{"title":"Postoperative adjuvant chemoradiotherapy versus postoperative adjuvant radiotherapy for head and neck squamous cell carcinoma with adverse pathology: a systematic review and meta-analysis","authors":"Gabriela Garcia Korczaguin ,&nbsp;Gilberto Vaz Teixeira ,&nbsp;Ashok Shaha","doi":"10.1016/j.bjorl.2024.101516","DOIUrl":"10.1016/j.bjorl.2024.101516","url":null,"abstract":"<div><h3>Objectives</h3><div>Postoperative chemoradiotherapy has arisen as an adjuvant option for head and neck cancers, but its superiority to radiotherapy alone in patients with adverse pathologic factors is not yet well defined. We aimed to perform an updated meta-analysis comparing outcomes in head and neck cancer patients with adverse pathologic factors who underwent postoperative chemoradiotherapy and radiotherapy alone.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Scopus and the Cochrane Central Register of Controlled Trials for Randomised Controlled Trials (RCTs) in patients submitted to postoperative adjuvant therapy with radiotherapy alone or chemoradiotherapy.</div></div><div><h3>Results</h3><div>We included 8 studies with a total of 2376 patients, of whom 1183 (49.8%) underwent postoperative chemoradiotherapy. In pooled analysis, overall survival (HR<!--> <!-->=<!--> <!-->0.86; 95% CI 0.76‒0.98; <em>p</em> <!-->=<!--> <!-->0.64; I² <!-->=<!--> <!-->0%) and disease-free survival (HR<!--> <!-->=<!--> <!-->0.85; 95% CI 0.75‒0.96; <em>p</em> <!-->=<!--> <!-->0.64; I² <!-->=<!--> <!-->0%) were shown to be superior in patients undergoing combined therapy. Chemoradiotherapy was also associated with significantly lower locoregional recurrence. However, there was no significant difference in distant metastasis occurrence between both groups. In an analysis of the extracapsular extension subgroup, the overall survival (OR<!--> <!-->=<!--> <!-->3.12; 95% CI 1.76–5.51; <em>p</em> <!-->=<!--> <!-->0.78; I² <!-->=<!--> <!-->0%), disease-free survival (OR<!--> <!-->=<!--> <!-->3.44; 95% CI 2.00‒5.91; <em>p</em> <!-->=<!--> <!-->0.68; I² <!-->=<!--> <!-->0%), and locoregional control (OR<!--> <!-->=<!--> <!-->1.86; 95% CI 1.16‒2.99; <em>p</em> <!-->=<!--> <!-->0.98; I² <!-->=<!--> <!-->0%) were better in the postoperative adjuvant chemoradiotherapy branch over radiotherapy alone.</div></div><div><h3>Conclusion</h3><div>The results of our meta-analysis suggest that postoperative adjuvant chemoradiotherapy in patients with head and neck cancer with adverse pathologic factors favors a superior survival and a better locoregional control compared to postoperative radiotherapy alone, despite not affecting the ocurrence of distant metastasis.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101516"},"PeriodicalIF":1.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560941","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}

{"title":"Brazilian Society of Otology task force – single sided deafness – recommendations based on strength of evidence","authors":"Robinson Koji Tsuji ,&nbsp;Rogério Hamerschmidt ,&nbsp;Joel Lavinsky ,&nbsp;Felippe Felix ,&nbsp;Vagner Antonio Rodrigues Silva","doi":"10.1016/j.bjorl.2024.101514","DOIUrl":"10.1016/j.bjorl.2024.101514","url":null,"abstract":"<div><h3>Objective</h3><div>To make evidence-based recommendations for the treatment of Single-Sided Deafness (SSD) in children and adults.</div></div><div><h3>Methods</h3><div>Task force members were instructed 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 SSD were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions.</div></div><div><h3>Results</h3><div>The topics were divided into 3 parts: (1) Impact of SSD in children; (2) Impact of SSD in adults; and (3) SSD in patients with temporal bone tumors.</div></div><div><h3>Conclusions</h3><div>Decision-making for patients with SSD is complex and multifactorial. The lack of consensus on the quality of outcomes and on which measurement tools to use hinders a proper comparison of different treatment options. Contralateral routing of signal hearing aids and bone conduction devices can alleviate the head shadow effect and improve sound awareness and signal-to-noise ratio in the affected ear. However, they cannot restore binaural hearing. Cochlear implants can restore binaural hearing, producing significant improvements in speech perception, spatial localization of sound, tinnitus control, and overall quality of life. However, cochlear implantation is not recommended in cases of cochlear nerve deficiency, a relatively common cause of congenital SSD.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101514"},"PeriodicalIF":1.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394596","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}

{"title":"Correlation between vestibular response to caloric stimulation and cochlear function in Ménière's disease","authors":"Leticia da Rosa Heinen ,&nbsp;Marcelo Assis Moro da Rocha Filho ,&nbsp;Artur Zanelatto Santos ,&nbsp;Amanda Calage Pinto ,&nbsp;Samuel Afonso de Freitas Toledo ,&nbsp;Luiz Lavinsky ,&nbsp;Joel Lavinsky","doi":"10.1016/j.bjorl.2024.101513","DOIUrl":"10.1016/j.bjorl.2024.101513","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the correlation between caloric testing response patterns with respect to cochlear impairment in individuals with unilateral Ménière's disease.</div></div><div><h3>Methods</h3><div>In this observational cross-sectional study, the factor under study was Ménière's disease and the outcome was cochleovestibular function, evaluated through caloric stimulation using videonystagmography and four-frequency averages in pure tone audiometry.</div></div><div><h3>Results</h3><div>A total of 187 patients (equal sex distribution) who met the inclusion criteria were included. In impairment analysis of the affected ear, 17 patients had only vestibular impairment, 56 had only cochlear impairment, and 114 had cochleovestibular impairment. The distribution of Ménière's disease stages according to four-frequency average was grade I: 23.53%, grade II: 16.04%, grade III: 42.25%, and grade IV: 18.18%. There was a significant association (<em>p</em> &lt; 0.001) between the affected ear and labyrinthine preponderance. The Spearman correlation between four-frequency average and labyrinth preponderance (<em>r</em> = 0.326) indicated a moderate correlation, considering <em>p</em> &lt; 0.01.</div></div><div><h3>Conclusion</h3><div>Our results show that the greater the cochlear damage due to Ménière's disease, the more impaired the vestibular function in the affected ear.</div></div><div><h3>Level of evidence</h3><div>Level 2 - Individual cross-sectional studies with consistently applied reference standard and blinding</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101513"},"PeriodicalIF":1.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394597","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}

{"title":"Brazilian Society of Otology task force – cochlear implant ‒ recommendations based on strength of evidence","authors":"Robinson Koji Tsuji ,&nbsp;Rogério Hamerschmidt ,&nbsp;Joel Lavinsky ,&nbsp;Felippe Felix ,&nbsp;Vagner Antonio Rodrigues Silva","doi":"10.1016/j.bjorl.2024.101512","DOIUrl":"10.1016/j.bjorl.2024.101512","url":null,"abstract":"<div><h3>Objective</h3><div>To make evidence-based recommendations for the indications and complications of Cochlear Implant (CI) surgery in adults and children.</div></div><div><h3>Methods</h3><div>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 cochlear implantation were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions.</div></div><div><h3>Results</h3><div>The topics were divided into 2 parts: (1) Evaluation of candidate patients and indications for CI surgery; (2) CI surgery – techniques and complications.</div></div><div><h3>Conclusions</h3><div>CI is a safe device for auditory rehabilitation of patients with severe-to-profound hearing loss. In recent years, indications for unilateral hearing loss and vestibular schwannoma have been expanded, with encouraging results. However, for a successful surgery, commitment of family members and patients in the hearing rehabilitation process is essential.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101512"},"PeriodicalIF":1.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511352","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}