Pub Date : 2024-09-10DOI: 10.1016/j.bjorl.2024.101510
Luana Perrone Camilo , Paula Vianna , Venancio Avancini Ferreira Alves , Beatriz Godoi Cavalheiro , Carlos Augusto Rossetti , Luiz Paulo Kowalski , Leandro Luongo Matos , Ana Kober Nogueira Leite
Objectives
The present study aims to characterize immunohistochemical features of markers associated with Epithelial–Mesenchymal Transition (EMT) and proliferative activity that could lead to death in Papillary Thyroid Cancer (PTC).
Methods
Clinical data and tumor material were retrospectively collected. The patients were separated into death from PTC (Group 1), metastatic cases with indolent behavior (Group 2) and non-metastatic indolent PTC (Group 3). Immunohistochemical assessment of E-cadherin, β-catenin, Vimentin, ZEB-1 and Ki-67 was performed in each tumor and a semiquantitative estimation of the percentage of expression was fulfilled on the best marking area at high of the tumor invasion front.
Results
31 patients were included, 15 that died from PTC (Group 1), 6 in Group 2 and 10 in Group 3. The proliferative marker Ki-67 showed a significant difference in its expression in the tumor invasion front between the groups, specifically between groups 1 and 3 (p = 0.006). On the other hand, EMT-related immunohistochemical markers did not show significant difference in their percentage of expression, since loss of E-cadherin, β-catenin and Vimentin was observed in most cases at the invasion front.
Conclusion
Patients that died from PTC had a significantly higher Ki-67 labelling index compared to patients with indolent disease (cutoff of 11%). Ki-67 may have a role as a prognostic marker and could be considered for routine use in PTC.
{"title":"Evaluation of epithelial-to-mesenchymal transition and Ki-67 index in aggressive papillary thyroid cancer","authors":"Luana Perrone Camilo , Paula Vianna , Venancio Avancini Ferreira Alves , Beatriz Godoi Cavalheiro , Carlos Augusto Rossetti , Luiz Paulo Kowalski , Leandro Luongo Matos , Ana Kober Nogueira Leite","doi":"10.1016/j.bjorl.2024.101510","DOIUrl":"10.1016/j.bjorl.2024.101510","url":null,"abstract":"<div><h3>Objectives</h3><div>The present study aims to characterize immunohistochemical features of markers associated with Epithelial–Mesenchymal Transition (EMT) and proliferative activity that could lead to death in Papillary Thyroid Cancer (PTC).</div></div><div><h3>Methods</h3><div>Clinical data and tumor material were retrospectively collected. The patients were separated into death from PTC (Group 1), metastatic cases with indolent behavior (Group 2) and non-metastatic indolent PTC (Group 3). Immunohistochemical assessment of E-cadherin, β-catenin, Vimentin, ZEB-1 and Ki-67 was performed in each tumor and a semiquantitative estimation of the percentage of expression was fulfilled on the best marking area at high of the tumor invasion front.</div></div><div><h3>Results</h3><div>31 patients were included, 15 that died from PTC (Group 1), 6 in Group 2 and 10 in Group 3. The proliferative marker Ki-67 showed a significant difference in its expression in the tumor invasion front between the groups, specifically between groups 1 and 3 (<em>p</em> = 0.006). On the other hand, EMT-related immunohistochemical markers did not show significant difference in their percentage of expression, since loss of E-cadherin, β-catenin and Vimentin was observed in most cases at the invasion front.</div></div><div><h3>Conclusion</h3><div>Patients that died from PTC had a significantly higher Ki-67 labelling index compared to patients with indolent disease (cutoff of 11%). Ki-67 may have a role as a prognostic marker and could be considered for routine use in PTC.</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 101510"},"PeriodicalIF":1.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401719","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}
Pub Date : 2024-09-10DOI: 10.1016/j.bjorl.2024.101509
Lihua Yue, Xiao Liu, Hongyan Liu, Haina Ma
<div><h3>Objectives</h3><div>To clarify the hearing outcomes after endoscopic type I tympanoplasty for medium and large perforations due to chronic otitis media.</div></div><div><h3>Methods</h3><div>We examined the clinical records of patients who underwent endoscopic type I tympanoplasty for medium and large perforations of the eardrum resulting from chronic otitis media between January 2019 and December 2021. We analyzed the changes in hearing pre- and post-operation in patients with healed eardrums and assessed the impact of tympanosclerosis on hearing. Patients with incomplete follow-up data, middle ear cholesteatoma, stapes fixation, severe lesions in the tympanic antrum and mastoid necessitating mastoidectomy and/or ossicular chain reconstruction were excluded.</div></div><div><h3>Results</h3><div>A total of 156 patients underwent analysis for audiological outcomes. Among them, 63 had medium tympanic membrane perforations, with 18 cases showing calcification of the tympanic membrane and 20 cases with calcification in the tympanic cavity. Additionally, 93 cases had large tympanic membrane perforations, with 25 cases showing tympanic membrane calcification and 32 cases with tympanic cavity calcification. Prior to surgery, the Air Conduction threshold (AC) in the large perforation group was higher than in the medium perforation group, particularly at low frequencies, measuring (47.4 ± 13.3 dB) and (41.2 ± 14.7 dB), respectively (<em>p</em>-value < 0.05). Following surgery, both groups experienced an improvement in AC, measuring (33.6 ± 13.9 dB) and (32.6 ± 12.8 dB), respectively, with no significant difference noted (<em>p</em>-value > 0.05). There was no significant change in Bone Conduction threshold (BC) before and after surgery in either the large or medium perforation groups (all <em>p</em>-values > 0.05). Except for 4000 Hz an increase, bone conduction did not increase post-surgery, instead showing further improved. Pre-surgery, the Air-Bone Gap (ABG) in the large and medium perforation groups was (27.7 ± 8.5 dB) and (21.8 ± 8.3 dB), respectively, mainly affecting low frequencies, with a statistically significant difference noted (<em>p</em>-value < 0.05). Following surgery, ABG in both groups improved to (16.3 ± 7.6 dB) and (15.7 ± 8.4 dB), respectively, with no significant difference observed (<em>p</em>-value > 0.05). There was no significant difference in hearing pre-surgery among the groups with No calcification (No), Tympanic Membrane Calcification (TM), and Tympanic Cavity Calcification (TC). However, TC significantly impacted low frequency (250–500 Hz) AC and ABG. The differences in AC and ABG pre-surgery between TC and No group, and TC and TM group (at 250–500 Hz) were statistically significant (all <em>p</em>-values < 0.05). Preoperative ABG in TM group was better than in No group and TC group, suggesting minimal impact of tympanic membrane calcification on hearing. No interaction was observed between tympanic
{"title":"Hearing results following endoscopic type I tympanoplasty in medium and large perforations","authors":"Lihua Yue, Xiao Liu, Hongyan Liu, Haina Ma","doi":"10.1016/j.bjorl.2024.101509","DOIUrl":"10.1016/j.bjorl.2024.101509","url":null,"abstract":"<div><h3>Objectives</h3><div>To clarify the hearing outcomes after endoscopic type I tympanoplasty for medium and large perforations due to chronic otitis media.</div></div><div><h3>Methods</h3><div>We examined the clinical records of patients who underwent endoscopic type I tympanoplasty for medium and large perforations of the eardrum resulting from chronic otitis media between January 2019 and December 2021. We analyzed the changes in hearing pre- and post-operation in patients with healed eardrums and assessed the impact of tympanosclerosis on hearing. Patients with incomplete follow-up data, middle ear cholesteatoma, stapes fixation, severe lesions in the tympanic antrum and mastoid necessitating mastoidectomy and/or ossicular chain reconstruction were excluded.</div></div><div><h3>Results</h3><div>A total of 156 patients underwent analysis for audiological outcomes. Among them, 63 had medium tympanic membrane perforations, with 18 cases showing calcification of the tympanic membrane and 20 cases with calcification in the tympanic cavity. Additionally, 93 cases had large tympanic membrane perforations, with 25 cases showing tympanic membrane calcification and 32 cases with tympanic cavity calcification. Prior to surgery, the Air Conduction threshold (AC) in the large perforation group was higher than in the medium perforation group, particularly at low frequencies, measuring (47.4 ± 13.3 dB) and (41.2 ± 14.7 dB), respectively (<em>p</em>-value < 0.05). Following surgery, both groups experienced an improvement in AC, measuring (33.6 ± 13.9 dB) and (32.6 ± 12.8 dB), respectively, with no significant difference noted (<em>p</em>-value > 0.05). There was no significant change in Bone Conduction threshold (BC) before and after surgery in either the large or medium perforation groups (all <em>p</em>-values > 0.05). Except for 4000 Hz an increase, bone conduction did not increase post-surgery, instead showing further improved. Pre-surgery, the Air-Bone Gap (ABG) in the large and medium perforation groups was (27.7 ± 8.5 dB) and (21.8 ± 8.3 dB), respectively, mainly affecting low frequencies, with a statistically significant difference noted (<em>p</em>-value < 0.05). Following surgery, ABG in both groups improved to (16.3 ± 7.6 dB) and (15.7 ± 8.4 dB), respectively, with no significant difference observed (<em>p</em>-value > 0.05). There was no significant difference in hearing pre-surgery among the groups with No calcification (No), Tympanic Membrane Calcification (TM), and Tympanic Cavity Calcification (TC). However, TC significantly impacted low frequency (250–500 Hz) AC and ABG. The differences in AC and ABG pre-surgery between TC and No group, and TC and TM group (at 250–500 Hz) were statistically significant (all <em>p</em>-values < 0.05). Preoperative ABG in TM group was better than in No group and TC group, suggesting minimal impact of tympanic membrane calcification on hearing. No interaction was observed between tympanic","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101509"},"PeriodicalIF":1.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401720","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}
Pub Date : 2024-09-07DOI: 10.1016/j.bjorl.2024.101500
Dirceu Solé , Fábio Chigres Kuschnir , Antônio Carlos Pastorino , Clóvis F. Constantino , Clóvis Galvão , Débora Carla Chong e Silva , Eduardo Baptistella , Ekaterini Simões Goudouris , Eulália Sakano , Fábio Ejzenbaum , Fausto Yoshio Matsumoto , Flavio Massao Mizoguchi , Fernando Monteiro Aarestrup , Gustavo F. Wandalsen , Herberto José Chong Neto , João Vianney Brito de Oliveira , José Faibes Lubianca Neto , Maria Cândida V. Rizzo , Maria Letícia Freitas Silva Chavarria , Marilyn Urrutia-Pereira , João Ferreira de Mello Júnior
Since we published the “IV Brazilian Consensus on Rhinitis”, in 2017, several advances have been achieved and have enabled a further understanding of the different aspects of “Rhinitis”. This new guideline, developed jointly by ASBAI, SBP and SBORL, represents a relevant milestone in the updated and integrated management of the different forms of the disease, and it aims to unify evidence-based approaches to improve the diagnosis and treatment of this common and often underestimated condition. The document covers a wide range of topics, including clear definitions of the different phenotypes and endotypes of rhinitis, risk factors, updated diagnostic criteria, and recommended methods for clinical and laboratory investigation. We stress the importance of detailed clinical history and objective assessment, as well as tools for control and assessing severity tools an accurate diagnostic approach to the disease. Regarding treatment, it emphasizes the treatment customization, considering the severity of symptoms, the presence of comorbidities and the impact on the patient's quality of life. We discuss different drug treatment, in addition to non-pharmacological measures, such as environmental control and specific immunotherapy; and the possible role of immunobiological agents. Furthermore, the consensus addresses issues related to patient education, prevention and management of special situations, such as rhinitis in children, in pregnant women and in the elderly. In short, the “V Brazilian Consensus on Rhinitis” represents a comprehensive and updated guide for healthcare professionals involved in the diagnosis and management of rhinitis, aiming to improve patients' quality of life through an integrated and evidence-based approach.
{"title":"V Brazilian Consensus on Rhinitis – 2024","authors":"Dirceu Solé , Fábio Chigres Kuschnir , Antônio Carlos Pastorino , Clóvis F. Constantino , Clóvis Galvão , Débora Carla Chong e Silva , Eduardo Baptistella , Ekaterini Simões Goudouris , Eulália Sakano , Fábio Ejzenbaum , Fausto Yoshio Matsumoto , Flavio Massao Mizoguchi , Fernando Monteiro Aarestrup , Gustavo F. Wandalsen , Herberto José Chong Neto , João Vianney Brito de Oliveira , José Faibes Lubianca Neto , Maria Cândida V. Rizzo , Maria Letícia Freitas Silva Chavarria , Marilyn Urrutia-Pereira , João Ferreira de Mello Júnior","doi":"10.1016/j.bjorl.2024.101500","DOIUrl":"10.1016/j.bjorl.2024.101500","url":null,"abstract":"<div><div>Since we published the “IV Brazilian Consensus on Rhinitis”, in<!--> <!-->2017, several advances have been achieved and have enabled a further understanding of the different aspects of “Rhinitis”. This new guideline, developed jointly by ASBAI, SBP and SBORL, represents a relevant milestone in the updated and integrated management of the different forms of the disease, and it aims to unify evidence-based approaches to improve the diagnosis and treatment of this common and often underestimated condition. The document covers a wide range of topics, including clear definitions of the different phenotypes and endotypes of rhinitis, risk factors, updated diagnostic criteria, and recommended methods for clinical and laboratory investigation. We stress the importance of detailed clinical history and objective assessment, as well as tools for control and assessing severity tools an accurate diagnostic approach to the disease. Regarding treatment, it emphasizes the treatment customization, considering the severity of symptoms, the presence of comorbidities and the impact on the patient's quality of life. We discuss different drug treatment, in addition to non-pharmacological measures, such as environmental control and specific immunotherapy; and the possible role of immunobiological agents. Furthermore, the consensus addresses issues related to patient education, prevention and management of special situations, such as rhinitis in children, in pregnant women and in the elderly. In short, the “V Brazilian Consensus on Rhinitis” represents a comprehensive and updated guide for healthcare professionals involved in the diagnosis and management of rhinitis, aiming to improve patients' quality of life through an integrated and evidence-based approach.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101500"},"PeriodicalIF":1.7,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401721","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}
The aim of this study is to evaluate mastoid volume and dimensions in patients with unilateral microtia using High-Resolution Computed Tomography (HRCT) to enhance the precision of reconstructive surgical planning.
Methods
A retrospective analysis of HRCT mastoid scans from patients with unilateral microtia was carried out at Cipto Mangunkusumo General Hospital between May 2020 and August 2022. Parameters such as mastoid volume, height, and surface area were measured at the ear canal, Superior Semicircular Canal (SCC), and lateral SCC levels.
Results
The analysis revealed statistically significant decreases in median mastoid air cell volume and mastoid bone volume in the affected ears compared to contralateral ears (p = 0.0312 and p = 0.02, respectively). Additionally, decreased mastoid height and surface areas at the ear canal and superior SCC levels were identified in affected ears (p < 0.05).
Conclusions
Patients with unilateral microtia have diminished mastoid bone volumetric parameters and dimensions on the affected side. These findings offer critical data for surgeons in preoperative planning, enabling the selection of appropriate reconstructive techniques and providing comprehensive patient counselling.
Level of evidence
Level 4.
本研究旨在使用高分辨率计算机断层扫描（HRCT）评估单侧小耳症患者的乳突体积和尺寸，以提高重建手术规划的精确度。方法在2020年5月至2022年8月期间，Cipto Mangunkusumo综合医院对单侧小耳症患者的HRCT乳突扫描进行了回顾性分析。在耳道、上半规管（SCC）和侧规管水平测量了乳突体积、高度和表面积等参数。结果分析表明，与对侧耳相比，患侧耳乳突气胞体积和乳突骨体积的中位数有统计学意义的显著下降（分别为 p = 0.0312 和 p = 0.02）。结论单侧小耳畸形患者患侧乳突骨体积参数和尺寸减小。这些发现为外科医生制定术前计划提供了重要数据，使他们能够选择适当的重建技术，并为患者提供全面的咨询服务。
{"title":"Evaluation of mastoid volume and dimensions in unilateral microtia patients: retrospective study using High Resolution Computed Tomography (HRCT)","authors":"Trimartani Koento , Anita Amalia Sari , Mirta Hediyati Reksodiputro , Harim Priyono , Semiramis Zizlavsky , Reyhan Eddy Yunus , Joedo Prihartono , Mikhael Yosia","doi":"10.1016/j.bjorl.2024.101501","DOIUrl":"10.1016/j.bjorl.2024.101501","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study is to evaluate mastoid volume and dimensions in patients with unilateral microtia using High-Resolution Computed Tomography (HRCT) to enhance the precision of reconstructive surgical planning.</div></div><div><h3>Methods</h3><div>A retrospective analysis of HRCT mastoid scans from patients with unilateral microtia was carried out at Cipto Mangunkusumo General Hospital between May 2020 and August 2022. Parameters such as mastoid volume, height, and surface area were measured at the ear canal, Superior Semicircular Canal (SCC), and lateral SCC levels.</div></div><div><h3>Results</h3><div>The analysis revealed statistically significant decreases in median mastoid air cell volume and mastoid bone volume in the affected ears compared to contralateral ears (<em>p</em> = 0.0312 and <em>p</em> = 0.02, respectively). Additionally, decreased mastoid height and surface areas at the ear canal and superior SCC levels were identified in affected ears (<em>p</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>Patients with unilateral microtia have diminished mastoid bone volumetric parameters and dimensions on the affected side. These findings offer critical data for surgeons in preoperative planning, enabling the selection of appropriate reconstructive techniques and providing comprehensive patient counselling.</div></div><div><h3>Level of evidence</h3><div>Level 4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101501"},"PeriodicalIF":1.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424001162/pdfft?md5=bcbfabefe33d064253b97bcdf0bb80a2&pid=1-s2.0-S1808869424001162-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316220","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}
Pub Date : 2024-09-03DOI: 10.1016/j.bjorl.2024.101489
Talita Parente Rodrigues , Viviane Carvalho da Silva , Ana Maria Almeida de Sousa , Tino Miro Aurélio Marques , Emanuel Saraiva Carvalho Feitosa , Marcos Rabelo de Freitas
Objectives
Vestibular migraine is a neurological disorder characterized by the association of vertigo and headache, affecting up to 1% of the population. Among its differential diagnoses is endolymphatic hydrops. The aim of this study was to investigate the role of cervical vestibular-evoked myogenic potential and electrocochleography in the diagnosis of vestibular migraine.
Method
Thirteen women with clinical diagnosis of vestibular migraine (mean age 44 years) and 13 healthy volunteers without auditory and/or vestibular complaints matched for sex and age were evaluated by performing hydrops examinations of cervical vestibular-evoked myogenic potential and electrocochleography.
Results
The presence of vertigo and headache was reported by all members of the group with vestibular migraine, associated with symptoms such as nausea, photophobia, and phonophobia. Tinnitus was the most frequent auditory complaint. A significant increase in P1 and N1 latencies was observed in the test group. There was no significant difference in the occurrence of asymmetry and decreased amplitude of the cervical vestibular-evoked myogenic potential. Electrocochleography showed an increase in amplitude of the summation potential. The altered SP/AP ratio was double in the group with vestibular migration, without statistical significance.
Conclusions
Changes in latency increase of cervical vestibular-evoked myogenic potential suggests a central lesion. Patients with vestibular migraine may present electrocochleography compatible with endolymphatic hydrops.
{"title":"Evaluation of cervical vestibular miogenic evoked potential and electrococleography in the diagnosis of vestibular migraine","authors":"Talita Parente Rodrigues , Viviane Carvalho da Silva , Ana Maria Almeida de Sousa , Tino Miro Aurélio Marques , Emanuel Saraiva Carvalho Feitosa , Marcos Rabelo de Freitas","doi":"10.1016/j.bjorl.2024.101489","DOIUrl":"10.1016/j.bjorl.2024.101489","url":null,"abstract":"<div><h3>Objectives</h3><p>Vestibular migraine is a neurological disorder characterized by the association of vertigo and headache, affecting up to 1% of the population. Among its differential diagnoses is endolymphatic hydrops. The aim of this study was to investigate the role of cervical vestibular-evoked myogenic potential and electrocochleography in the diagnosis of vestibular migraine.</p></div><div><h3>Method</h3><p>Thirteen women with clinical diagnosis of vestibular migraine (mean age 44 years) and 13 healthy volunteers without auditory and/or vestibular complaints matched for sex and age were evaluated by performing hydrops examinations of cervical vestibular-evoked myogenic potential and electrocochleography.</p></div><div><h3>Results</h3><p>The presence of vertigo and headache was reported by all members of the group with vestibular migraine, associated with symptoms such as nausea, photophobia, and phonophobia. Tinnitus was the most frequent auditory complaint. A significant increase in P1 and N1 latencies was observed in the test group. There was no significant difference in the occurrence of asymmetry and decreased amplitude of the cervical vestibular-evoked myogenic potential. Electrocochleography showed an increase in amplitude of the summation potential. The altered SP/AP ratio was double in the group with vestibular migration, without statistical significance.</p></div><div><h3>Conclusions</h3><p>Changes in latency increase of cervical vestibular-evoked myogenic potential suggests a central lesion. Patients with vestibular migraine may present electrocochleography compatible with endolymphatic hydrops.</p></div><div><h3>Level of evidence</h3><p>Level 4.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"90 6","pages":"Article 101489"},"PeriodicalIF":1.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424001046/pdfft?md5=570e291654172bcc5766ca34d46860cb&pid=1-s2.0-S1808869424001046-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232604","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}
Pub Date : 2024-09-02DOI: 10.1016/j.bjorl.2024.101490
Débora de Carvalho Garcez , Miguel Soares Tepedino , Debora Petrungaro Migueis , Pedro Miño Vianna , Andrea Santos Dumont Costacurta , Elyzabeth Avvad Portari , Alexandre Malta da Costa Messeder , Richard Louis Voegels , Alexandre Coelho Boggi , Reginaldo Raimundo Fujita , Andrew Thamboo , Rogério Pezato
Objectives
Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP) is a disease characterized by chronic inflammation and tissue remodeling process. The remodeling process in nasal polyps has mainly been studied by histology analysis. However, it is limited to a polyp fragment and requires tissue removal. The present study aims to evaluate the ability of Magnetic Resonance Imaging (MRI) to depict and characterize the remodeling process in patients with CRSwNP.
Methods
30 patients that met clinical diagnostic criteria for CRSwNP, without previous history of rhinosinusitis surgery were submitted to MRI scan (conventional, diffusion-weighted and DCE MRI) and compared with polyp tissue histological findings, IL-6 concentrations in the tissue and eosinophil count in the blood. The examinations were evaluated, independently, by two radiologists blinded to other radiological and histological data. The pathologist, blinded to MRI results, also compared the tissue sample from the most central and the most peripheral portion of the polypoid tissue adjacent to the floor of the nasal fossa.
Results
This study demonstrated a characteristic pattern of nasal polyps, whose peripheral portions of nasal polypoid tissue are edematous, whereas the central portions in the middle meatus and in the middle and upper ethmoid are predominantly fibrotic. ADC values found in the most anterior portion of the polyps may be a marker for radiological phenotyping the remodeling process. This non-invasive analysis presented a high degree of agreement in the fibrosis and edema rating by two radiologists and the histological analysis was concordant with the MRI findings. The polyps were characterized as eosinophilic, and no relationship was found between the severity of the eosinophilic inflammatory process or concentration of IL-6 and the remodeling process.
Conclusion
MRI by using T2-weighted imaging sequence and ADCs values allows tissue characterization and is an effective tool for the differentiation of edematous and fibrotic components in CRSwNP.
{"title":"A proposal for analyzing the inflammatory and remodeling processes of mucosa in chronic rhinosinusitis with nasal polyposis through MRI","authors":"Débora de Carvalho Garcez , Miguel Soares Tepedino , Debora Petrungaro Migueis , Pedro Miño Vianna , Andrea Santos Dumont Costacurta , Elyzabeth Avvad Portari , Alexandre Malta da Costa Messeder , Richard Louis Voegels , Alexandre Coelho Boggi , Reginaldo Raimundo Fujita , Andrew Thamboo , Rogério Pezato","doi":"10.1016/j.bjorl.2024.101490","DOIUrl":"10.1016/j.bjorl.2024.101490","url":null,"abstract":"<div><h3>Objectives</h3><p>Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP) is a disease characterized by chronic inflammation and tissue remodeling process. The remodeling process in nasal polyps has mainly been studied by histology analysis. However, it is limited to a polyp fragment and requires tissue removal. The present study aims to evaluate the ability of Magnetic Resonance Imaging (MRI) to depict and characterize the remodeling process in patients with CRSwNP.</p></div><div><h3>Methods</h3><p>30 patients that met clinical diagnostic criteria for CRSwNP, without previous history of rhinosinusitis surgery were submitted to MRI scan (conventional, diffusion-weighted and DCE MRI) and compared with polyp tissue histological findings, IL-6 concentrations in the tissue and eosinophil count in the blood. The examinations were evaluated, independently, by two radiologists blinded to other radiological and histological data. The pathologist, blinded to MRI results, also compared the tissue sample from the most central and the most peripheral portion of the polypoid tissue adjacent to the floor of the nasal fossa.</p></div><div><h3>Results</h3><p>This study demonstrated a characteristic pattern of nasal polyps, whose peripheral portions of nasal polypoid tissue are edematous, whereas the central portions in the middle meatus and in the middle and upper ethmoid are predominantly fibrotic. ADC values found in the most anterior portion of the polyps may be a marker for radiological phenotyping the remodeling process. This non-invasive analysis presented a high degree of agreement in the fibrosis and edema rating by two radiologists and the histological analysis was concordant with the MRI findings. The polyps were characterized as eosinophilic, and no relationship was found between the severity of the eosinophilic inflammatory process or concentration of IL-6 and the remodeling process.</p></div><div><h3>Conclusion</h3><p>MRI by using T2-weighted imaging sequence and ADCs values allows tissue characterization and is an effective tool for the differentiation of edematous and fibrotic components in CRSwNP.</p></div><div><h3>Level of evidence</h3><p>3.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"90 6","pages":"Article 101490"},"PeriodicalIF":1.7,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424001058/pdfft?md5=3100f007cc6065ed2b0d7a365b6cfae5&pid=1-s2.0-S1808869424001058-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142158392","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}
Pub Date : 2024-09-02DOI: 10.1016/j.bjorl.2024.101497
André Luiz Lisboa Cordeiro , Hayssa de Cássia Mascarenhas Barbosa , Daniel Silva Mascarenhas Junior , Jandesson Cena dos Santos , André Raimundo França Guimarães
Objective
To describe pulmonary function, muscle strength and functional performance in the different qualities of sleep and the impact of this on the number of physiotherapeutic assistances.
Methods
This is an observational study. In the pre and post operative period, sleep behavior was evaluated using the Pittsburgh questionnaire. Patients were divided into three groups: Good Sleep Quality (GSQ), Poor Sleep Quality (PSQ) and Sleep Disordered (SDB). At this time, other tests were also performed, such as: 6-Minute Walk Test (6MWT), Sit and Stand Test (SST), gait speed test and Timed Up to Go (TUG), Medical Research Council (MRC), maximal inspiratory pressure and maximal expiratory, vital capacity and peak expiratory flow. The functional performance and lung function of each group were compared.
Results
A total of 105 people, undergoing cardiac surgery and admitted to hospital were evaluated, 33 with GSQ, 41 with PSQ and 31 with SD. Patients who were in the SDB group had a lower functional performance than the other groups. 6MWT (meters) in the GSQ was 499 ± 87, versus 487 ± 91 in the PSQ and 430 ± 78 in the SD (p = 0.02). In the SST (seconds) it was 10.4 ± 1.1 in the GQS, 11.1 ± 2.3 in the PSQ and 15.4 ± 2.1 in the SD (p = 0.04). Lung function and muscle strength did not differ between groups. Regarding the refusal to perform physical therapy, the SD group was more incident, the main reason being drowsiness.
Conclusion
Based on the results, we found that sleep quality interferes with functional performance and physical therapy assistance during the hospital stay in patients undergoing cardiac surgery.
{"title":"Functional performance of patients submitted to cardiac surgery with different levels of sleep quality: an observational study","authors":"André Luiz Lisboa Cordeiro , Hayssa de Cássia Mascarenhas Barbosa , Daniel Silva Mascarenhas Junior , Jandesson Cena dos Santos , André Raimundo França Guimarães","doi":"10.1016/j.bjorl.2024.101497","DOIUrl":"10.1016/j.bjorl.2024.101497","url":null,"abstract":"<div><h3>Objective</h3><p>To describe pulmonary function, muscle strength and functional performance in the different qualities of sleep and the impact of this on the number of physiotherapeutic assistances.</p></div><div><h3>Methods</h3><p>This is an observational study. In the pre and post operative period, sleep behavior was evaluated using the Pittsburgh questionnaire. Patients were divided into three groups: Good Sleep Quality (GSQ), Poor Sleep Quality (PSQ) and Sleep Disordered (SDB). At this time, other tests were also performed, such as: 6-Minute Walk Test (6MWT), Sit and Stand Test (SST), gait speed test and Timed Up to Go (TUG), Medical Research Council (MRC), maximal inspiratory pressure and maximal expiratory, vital capacity and peak expiratory flow. The functional performance and lung function of each group were compared.</p></div><div><h3>Results</h3><p>A total of 105 people, undergoing cardiac surgery and admitted to hospital were evaluated, 33 with GSQ, 41 with PSQ and 31 with SD. Patients who were in the SDB group had a lower functional performance than the other groups. 6MWT (meters) in the GSQ was 499 ± 87, versus 487 ± 91 in the PSQ and 430 ± 78 in the SD (<em>p</em> = 0.02). In the SST (seconds) it was 10.4 ± 1.1 in the GQS, 11.1 ± 2.3 in the PSQ and 15.4 ± 2.1 in the SD (<em>p</em> = 0.04). Lung function and muscle strength did not differ between groups. Regarding the refusal to perform physical therapy, the SD group was more incident, the main reason being drowsiness.</p></div><div><h3>Conclusion</h3><p>Based on the results, we found that sleep quality interferes with functional performance and physical therapy assistance during the hospital stay in patients undergoing cardiac surgery.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"90 6","pages":"Article 101497"},"PeriodicalIF":1.7,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424001125/pdfft?md5=6c9111ab10da4faac1a14f4812b68040&pid=1-s2.0-S1808869424001125-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142151156","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}
Pub Date : 2024-09-02DOI: 10.1016/j.bjorl.2024.101498
Thales Victor Fernandes Ferreira , Ana Luíza Cézar Fernandes , Mário Pinheiro Espósito
Objective
To comprehensively analyze the benefits and harms associated with the use of isotretinoin as a skin preparation agent for rhinoplasty.
Method
A systematic review of the literature was carried out, conducted through a comprehensive search in scientific databases: LILACS and PUBMED.
Results
Although isotretinoin has beneficial effects on skin preparation, some studies indicate that its continuous use before rhinoplasty may interfere with healing, suggesting the need for a period of suspension prior to the procedure. Other concerns include the impact on blood levels, increasing the risk of hematological changes, highlighting the importance of regular hematological monitoring during treatment. The decision to use isotretinoin as preparation for rhinoplasty must take into account the surgeon's experience and the specific characteristics of the patient, seeking to balance the aesthetic benefits with the potential risks.
Conclusion
The decision to use isotretinoin as part of skin preparation for rhinoplasty must be individualized, taking into account the specific characteristics of the patient, their aesthetic objectives and the assessment of risks and benefits. A collaborative approach between the plastic surgeon, dermatologist and patient is essential to ensure safe and effective use of isotretinoin, maximizing its benefits while minimizing the potential harm associated with this therapy.
{"title":"Importance of psychological follow-up in rhinoplasty","authors":"Thales Victor Fernandes Ferreira , Ana Luíza Cézar Fernandes , Mário Pinheiro Espósito","doi":"10.1016/j.bjorl.2024.101498","DOIUrl":"10.1016/j.bjorl.2024.101498","url":null,"abstract":"<div><h3>Objective</h3><div>To comprehensively analyze the benefits and harms associated with the use of isotretinoin as a skin preparation agent for rhinoplasty.</div></div><div><h3>Method</h3><div>A systematic review of the literature was carried out, conducted through a comprehensive search in scientific databases: LILACS and PUBMED.</div></div><div><h3>Results</h3><div>Although isotretinoin has beneficial effects on skin preparation, some studies indicate that its continuous use before rhinoplasty may interfere with healing, suggesting the need for a period of suspension prior to the procedure. Other concerns include the impact on blood levels, increasing the risk of hematological changes, highlighting the importance of regular hematological monitoring during treatment. The decision to use isotretinoin as preparation for rhinoplasty must take into account the surgeon's experience and the specific characteristics of the patient, seeking to balance the aesthetic benefits with the potential risks.</div></div><div><h3>Conclusion</h3><div>The decision to use isotretinoin as part of skin preparation for rhinoplasty must be individualized, taking into account the specific characteristics of the patient, their aesthetic objectives and the assessment of risks and benefits. A collaborative approach between the plastic surgeon, dermatologist and patient is essential to ensure safe and effective use of isotretinoin, maximizing its benefits while minimizing the potential harm associated with this therapy.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101498"},"PeriodicalIF":1.7,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322241","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}
The aim of this study was to construct a prognostic model based on the TP53 mutation to calculate prognostic risk scores of patients with HPSCC.
Methods
TP53 mutation and transcriptome data were downloaded from the TCGA databases. Gene expression data from GSE65858, GSE41613, GSE3292, GSE31056, GSE39366, and GSE227156 datasets were downloaded from the GEO database. GSEA, univariate, multivariate Cox analyses, and LASSO analysis were employed to identify key genes and construct the prognostic model. ROC curves were utilized to validate the OS and RFS results obtained from the model. The associations between risk scores with various clinicopathological characteristics and immune scores were analyzed via ggplot2, corrplot package, and GSVA, respectively. Single-cell sequencing data was analyzed via unbiased clustering and SingleR cell annotations.
Results
Initially, two key genes, POLD2 and POLR2G, were identified and utilized to construct the prognostic model. Samples were divided into different risk groups via the risk scores obtained from the model, with high-risk group samples exhibiting poorer prognosis. Furthermore, the risk score exhibited a positive correlation with lymphatic metastasis in patients and the immune scores of CD4+ T, CD8+ T, dendritic cell, macrophage, and neutrophil. The immune responses also exhibited notable disparities between the high- and low-risk groups. The results of single-cell sequencing analysis demonstrated that epithelial cells and macrophages were relatively abundant in HPSCC samples. POLD2 and POLR2G exhibited higher expressions in epithelial cells, with most of the identified pathways also enriched in epithelial cells.
Conclusion
The prognostic model exhibited a significant capacity for predicting the prognosis of HSPCC samples based on the TP53 mutation conditions and may also predict the cancer characteristics and immune infiltration scores of samples via different risk scores obtained from the model.
{"title":"Development of the TP53 mutation associated hypopharyngeal squamous cell carcinoma prognostic model through bulk multi-omics sequencing and single-cell sequencing","authors":"Ying Zhang, Yue Cui, Congfan Hao, Yingjie Li, Xinyang He, Wenhui Li, Hongyang Yu","doi":"10.1016/j.bjorl.2024.101499","DOIUrl":"10.1016/j.bjorl.2024.101499","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to construct a prognostic model based on the TP53 mutation to calculate prognostic risk scores of patients with HPSCC.</div></div><div><h3>Methods</h3><div>TP53 mutation and transcriptome data were downloaded from the TCGA databases. Gene expression data from GSE65858, GSE41613, GSE3292, GSE31056, GSE39366, and GSE227156 datasets were downloaded from the GEO database. GSEA, univariate, multivariate Cox analyses, and LASSO analysis were employed to identify key genes and construct the prognostic model. ROC curves were utilized to validate the OS and RFS results obtained from the model. The associations between risk scores with various clinicopathological characteristics and immune scores were analyzed via ggplot2, corrplot package, and GSVA, respectively. Single-cell sequencing data was analyzed via unbiased clustering and SingleR cell annotations.</div></div><div><h3>Results</h3><div>Initially, two key genes, POLD2 and POLR2G, were identified and utilized to construct the prognostic model. Samples were divided into different risk groups via the risk scores obtained from the model, with high-risk group samples exhibiting poorer prognosis. Furthermore, the risk score exhibited a positive correlation with lymphatic metastasis in patients and the immune scores of CD4<sup>+</sup> T, CD8<sup>+</sup> T, dendritic cell, macrophage, and neutrophil. The immune responses also exhibited notable disparities between the high- and low-risk groups. The results of single-cell sequencing analysis demonstrated that epithelial cells and macrophages were relatively abundant in HPSCC samples. POLD2 and POLR2G exhibited higher expressions in epithelial cells, with most of the identified pathways also enriched in epithelial cells.</div></div><div><h3>Conclusion</h3><div>The prognostic model exhibited a significant capacity for predicting the prognosis of HSPCC samples based on the TP53 mutation conditions and may also predict the cancer characteristics and immune infiltration scores of samples via different risk scores obtained from the model.</div></div><div><h3>Level of evidence</h3><div>Level 5.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101499"},"PeriodicalIF":1.7,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327461","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}
Pub Date : 2024-08-31DOI: 10.1016/j.bjorl.2024.101494
Giovana Piovesan Dall'Oglio , Eliézia Helena De Lima Alvarenga , Leonardo Haddad , Mateus Morais Aires , Márcio Abrahão
Objectives
To describe the findings of Fiberoptic Endoscopic Examination of Swallowing (FEES) in asymptomatic young and older adults, comparing results across different age groups. Additionally, this study aims to test the Eating Assessment Tool (EAT-10) as an instrument to identify dysphagia risk.
Methods
A prospective cross-sectional observational analysis was conducted on a sample of individuals aged 20 and above, asymptomatic for dysphagia, stratified by age groups. The EAT-10 questionnaire was completed, and the FEES was employed to assess oropharyngeal swallowing function. Various parameters, including salivary stasis, swallowing reflex trigger, swallowing sequence, residue, penetration, and aspiration were blindly analyzed by two otolaryngologists.
Results
A total of 184 participants were included, with a mean age of 44.7 ± 18.5 years. There was good to excellent agreement between examiners for FEES parameters. The EAT-10 score ≥3 suggested dysphagia risk in 7.6% (n = 14) of the sample, with no association with age or any FEES parameter. Individuals aged ≥80 years presented more residue (50%; n = 5/10) compared to younger individuals (11.5%; n = 20/174; p = 0.039). Salivary stasis was found exclusively in individuals aged ≥60 years (n = 5/39; 12.8%; p = 0.027). Age did not influence on the swallowing reflex trigger, swallowing sequence, penetration, and aspiration. Penetration was observed in 4.9% (n = 9) of subjects and aspiration occurred in 0.5% (n = 1) of subjects, with no statistical significance in age groups.
Conclusion
Age does not have a linear influence on swallowing in healthy adults and elderly people. However, individuals aged ≥80 years showed a higher prevalence of residue, and individuals aged ≥60 years showed a higher prevalence of salivary stasis, suggesting an increased risk or presence of dysphagia. Other FEES parameters were not influenced by age. These findings provide valuable insights into the nuanced dynamics of swallowing across different age groups, emphasizing the importance of age-specific considerations in dysphagia assessment.
{"title":"Profile of oropharyngeal swallowing in healthy Brazilian adults and older adults","authors":"Giovana Piovesan Dall'Oglio , Eliézia Helena De Lima Alvarenga , Leonardo Haddad , Mateus Morais Aires , Márcio Abrahão","doi":"10.1016/j.bjorl.2024.101494","DOIUrl":"10.1016/j.bjorl.2024.101494","url":null,"abstract":"<div><h3>Objectives</h3><p>To describe the findings of Fiberoptic Endoscopic Examination of Swallowing (FEES) in asymptomatic young and older adults, comparing results across different age groups. Additionally, this study aims to test the Eating Assessment Tool (EAT-10) as an instrument to identify dysphagia risk.</p></div><div><h3>Methods</h3><p>A prospective cross-sectional observational analysis was conducted on a sample of individuals aged 20 and above, asymptomatic for dysphagia, stratified by age groups. The EAT-10 questionnaire was completed, and the FEES was employed to assess oropharyngeal swallowing function. Various parameters, including salivary stasis, swallowing reflex trigger, swallowing sequence, residue, penetration, and aspiration were blindly analyzed by two otolaryngologists.</p></div><div><h3>Results</h3><p>A total of 184 participants were included, with a mean age of 44.7 ± 18.5 years. There was good to excellent agreement between examiners for FEES parameters. The EAT-10 score ≥3 suggested dysphagia risk in 7.6% (n = 14) of the sample, with no association with age or any FEES parameter. Individuals aged ≥80 years presented more residue (50%; n = 5/10) compared to younger individuals (11.5%; n = 20/174; <em>p</em> = 0.039). Salivary stasis was found exclusively in individuals aged ≥60 years (n = 5/39; 12.8%; <em>p</em> = 0.027). Age did not influence on the swallowing reflex trigger, swallowing sequence, penetration, and aspiration. Penetration was observed in 4.9% (n = 9) of subjects and aspiration occurred in 0.5% (n = 1) of subjects, with no statistical significance in age groups.</p></div><div><h3>Conclusion</h3><p>Age does not have a linear influence on swallowing in healthy adults and elderly people. However, individuals aged ≥80 years showed a higher prevalence of residue, and individuals aged ≥60 years showed a higher prevalence of salivary stasis, suggesting an increased risk or presence of dysphagia. Other FEES parameters were not influenced by age. These findings provide valuable insights into the nuanced dynamics of swallowing across different age groups, emphasizing the importance of age-specific considerations in dysphagia assessment.</p></div><div><h3>Level of evidence</h3><p>4.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101494"},"PeriodicalIF":1.7,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424001095/pdfft?md5=a8fc2d282a62448163909dace51d8c64&pid=1-s2.0-S1808869424001095-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271851","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}
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