Pub Date : 2025-09-20DOI: 10.1016/j.bjorl.2025.101698
Ke-Shuang Wang , Jun-Hao Tu , Qian-Xing Wang , Sui-Zi Zhou , Jia-Rong Wu , Qian-Hui Qiu
Objective
Gut microbiome dysbiosis is associated with various diseases. Causal association between Chronic Rhinosinusitis (CRS) and gut microbiome is yet unknown. This study aimed to investigate the potential causal relationship between CRS and gut microbiome dysbiosis.
Methods
We used Genome-Wide Association Study (GWAS) data from FinnGen database for CRS. The Dutch Microbiome Project study provided data on gut microbiota species. A total of 334,182 individuals were included. Two-sample bidirectional Mendelian Randomization (MR) analysis was used to investigate causal relationship between CRS and gut microbiome. The main methods of evaluation were Inverse Variance Weighting (IVW), weighted median, weighted mode, and MR-Egger regression. Sensitivity analyses were performed to assess heterogeneity and pleiotropy.
Results
Forward MR analysis indicated CRS is potentially linked to decreased risk of Haemophilus parainfluenzae (OR = 0.79, 95% CI 0.66‒0.94, p = 0.009) and increased risk of Bilophila’s (OR = 1.14, 95% CI 1.02–1.27, p = 0.023) within the gut. Reduced risks in gut microbiota-related pathways like UDP-N-acetyl-d-glucosamine biosynthesis I (OR = 0.85, 95% CI 0.77‒0.94, p = 0.002) and increased risk in pathway NAD biosynthesis I from aspartate (OR = 1.14, 95% CI 1.03–1.27, p = 0.010) were also linked to CRS. Reverse MR analyses, we obtained no positive results (p > 0.05/412).
Conclusion
This study reveals CRS exerts a causal impact on shifts within the composition of the gut microbiome and also links to the changes of gut microbiota-related metabolic pathways. The risk of changes in gut microbiota should be of greater concern in patients with CRS than in the general population.
Level of evidence
Mendelian Randomized (MR) studies are second only to randomized controlled trials in terms of the level of evidence.
目的肠道菌群失调与多种疾病有关。慢性鼻窦炎（CRS）与肠道微生物群之间的因果关系尚不清楚。本研究旨在探讨CRS与肠道微生物群失调之间的潜在因果关系。方法采用FinnGen数据库的全基因组关联研究（GWAS）数据进行CRS研究。荷兰微生物组项目研究提供了肠道菌群种类的数据。共纳入334182人。采用双样本双向孟德尔随机化（MR）分析研究CRS与肠道微生物组的因果关系。评价方法主要有方差反加权法（IVW）、加权中位数法、加权模式法和MR-Egger回归法。进行敏感性分析以评估异质性和多效性。结果前瞻性磁共振分析显示，CRS可能与肠道内副流感嗜血杆菌风险降低（OR = 0.79, 95% CI 0.66-0.94, p = 0.009）和嗜血杆菌风险增加（OR = 1.14, 95% CI 1.02-1.27, p = 0.023）有关。肠道菌群相关途径如udp - n -乙酰-d-葡萄糖胺生物合成I的风险降低（OR = 0.85, 95% CI 0.77-0.94, p = 0.002）和天冬氨酸NAD生物合成I途径的风险增加（OR = 1.14, 95% CI 1.03-1.27, p = 0.010）也与CRS有关。反向MR分析，我们没有得到阳性结果（p > 0.05/412）。结论CRS对肠道菌群组成的变化具有因果影响，并与肠道菌群相关代谢途径的变化有关。CRS患者肠道菌群变化的风险应比一般人群更值得关注。证据水平就证据水平而言，孟德尔随机（MR）研究仅次于随机对照试验。
{"title":"Alterations of gut microbiome in chronic rhinosinusitis: insights from a mendelian randomization study","authors":"Ke-Shuang Wang , Jun-Hao Tu , Qian-Xing Wang , Sui-Zi Zhou , Jia-Rong Wu , Qian-Hui Qiu","doi":"10.1016/j.bjorl.2025.101698","DOIUrl":"10.1016/j.bjorl.2025.101698","url":null,"abstract":"<div><h3>Objective</h3><div>Gut microbiome dysbiosis is associated with various diseases. Causal association between Chronic Rhinosinusitis (CRS) and gut microbiome is yet unknown. This study aimed to investigate the potential causal relationship between CRS and gut microbiome dysbiosis.</div></div><div><h3>Methods</h3><div>We used Genome-Wide Association Study (GWAS) data from FinnGen database for CRS. The Dutch Microbiome Project study provided data on gut microbiota species. A total of 334,182 individuals were included. Two-sample bidirectional Mendelian Randomization (MR) analysis was used to investigate causal relationship between CRS and gut microbiome. The main methods of evaluation were Inverse Variance Weighting (IVW), weighted median, weighted mode, and MR-Egger regression. Sensitivity analyses were performed to assess heterogeneity and pleiotropy.</div></div><div><h3>Results</h3><div>Forward MR analysis indicated CRS is potentially linked to decreased risk of <em>Haemophilus parainfluenzae</em> (OR = 0.79, 95% CI 0.66‒0.94, <em>p</em> = 0.009) and increased risk of Bilophila’s (OR = 1.14, 95% CI 1.02–1.27, <em>p</em> = 0.023) within the gut. Reduced risks in gut microbiota-related pathways like UDP<em>-N-</em>acetyl-<span>d</span>-glucosamine biosynthesis I (OR = 0.85, 95% CI 0.77‒0.94, <em>p</em> = 0.002) and increased risk in pathway NAD biosynthesis I from aspartate (OR = 1.14, 95% CI 1.03–1.27, <em>p</em> = 0.010) were also linked to CRS. Reverse MR analyses, we obtained no positive results (<em>p</em> > 0.05/412).</div></div><div><h3>Conclusion</h3><div>This study reveals CRS exerts a causal impact on shifts within the composition of the gut microbiome and also links to the changes of gut microbiota-related metabolic pathways. The risk of changes in gut microbiota should be of greater concern in patients with CRS than in the general population.</div></div><div><h3>Level of evidence</h3><div>Mendelian Randomized (MR) studies are second only to randomized controlled trials in terms of the level of evidence.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101698"},"PeriodicalIF":1.8,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145107491","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}
Pub Date : 2025-09-13DOI: 10.1016/j.bjorl.2025.101709
Min Huang , Guohao Chen
Objective
To investigate the plane and related mechanisms of tongue-originated obstruction in Obstructive Sleep Apnea Syndrome (OSAS) patients with macroglossia, utilizing pharyngeal Magnetic Resonance Imaging (MRI) in combination with Upper Airway Pressure Monitoring (UAPM).
Methods
Nineteen OSAS patients with macroglossia and 19 healthy controls were enrolled in this study. Every case was examined by pharyngeal MRI and Polysomnogram (PSG). The minimum Retropalatal Space (RP), the minimum Retrolingual Space (RL), soft palate thickness and the minimum space from the dorsal tongue to the soft palate (TP) were measured on a midsagittal plane. UAPM was measured only in the OSAS group. The differences of results between groups were statistically analyzed.
Results
Both UAPM and pharyngeal MRI indicated that the obstruction plane was present in patients with OSAS along the velopharyngeal plane. The mean values of both RP and RP/RL of patients with OSAS in this study were significantly smaller than control group values (p < 0.05). There was no significant difference in RL and soft palate thickness across the two groups (p > 0.05). The value of TP in both groups was close to 0, showing no significant difference between groups (p > 0.05).
Conclusions
The velopharyngeal plane was the most common site demonstrating obstructive etiology in OSAS patients with macroglossia. The related mechanism is suspected to include the backward movement of the soft palate caused by the high arch and the fall of the middle segment of the hypertrophic tongue. These findings may inform tongue-related surgical site decision-making for OSAS patients with macroglossia.
{"title":"Analysis on the plane and mechanism of tongue-originated obstruction in Obstructive Sleep Apnea Syndrome (OSAS) patients with macroglossia","authors":"Min Huang , Guohao Chen","doi":"10.1016/j.bjorl.2025.101709","DOIUrl":"10.1016/j.bjorl.2025.101709","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the plane and related mechanisms of tongue-originated obstruction in Obstructive Sleep Apnea Syndrome (OSAS) patients with macroglossia, utilizing pharyngeal Magnetic Resonance Imaging (MRI) in combination with Upper Airway Pressure Monitoring (UAPM).</div></div><div><h3>Methods</h3><div>Nineteen OSAS patients with macroglossia and 19 healthy controls were enrolled in this study. Every case was examined by pharyngeal MRI and Polysomnogram (PSG). The minimum Retropalatal Space (RP), the minimum Retrolingual Space (RL), soft palate thickness and the minimum space from the dorsal tongue to the soft palate (TP) were measured on a midsagittal plane. UAPM was measured only in the OSAS group. The differences of results between groups were statistically analyzed.</div></div><div><h3>Results</h3><div>Both UAPM and pharyngeal MRI indicated that the obstruction plane was present in patients with OSAS along the velopharyngeal plane. The mean values of both RP and RP/RL of patients with OSAS in this study were significantly smaller than control group values (<em>p</em> < 0.05). There was no significant difference in RL and soft palate thickness across the two groups (<em>p</em> > 0.05). The value of TP in both groups was close to 0, showing no significant difference between groups (<em>p</em> > 0.05).</div></div><div><h3>Conclusions</h3><div>The velopharyngeal plane was the most common site demonstrating obstructive etiology in OSAS patients with macroglossia. The related mechanism is suspected to include the backward movement of the soft palate caused by the high arch and the fall of the middle segment of the hypertrophic tongue. These findings may inform tongue-related surgical site decision-making for OSAS patients with macroglossia.</div></div><div><h3>Level of evidence</h3><div>IV: Retrospective cohort study.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101709"},"PeriodicalIF":1.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050236","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}
Pub Date : 2025-09-13DOI: 10.1016/j.bjorl.2025.101710
Rogério Aparecido Dedivitis , Mario Augusto Ferrari de Castro , Fátima Cristina Mendes de Matos , Marianne Yumi Nakai , Leandro Luongo de Matos , Marco Aurélio Vamondes Kulcsar , Carlos Takahiro Chone , Luiz Paulo Kowalski , Fernando Luiz Dias , André Cruz Martins , Bruna Carteiro Silva
Objectives
To standardize the necessary competencies for Head and Neck Surgery residents related to the specialty.
Methods
The Delphi process was employed in its sequential phases: the selection of an expert panel; a structured questionnaire containing a preliminary list of potential competencies; the electronic distribution of the questionnaire to the experts, with options to “maintain”, “remove”, or “modify” the competencies and to suggest the inclusion of new competencies; a second round indicating “agree” or “disagree” for each reformulated or new competency; and the final consensus.
Results
Forty-six competencies were established for Head and Neck Surgery residents in the specialty.
Conclusion
Head and Neck Surgery residents and fellows should be trained in depth for the competency framework encompassing both routine and complex surgical interventions.
{"title":"Competencies in head and neck surgery teaching for specialty residents. Position statement of Brazilian Head and Neck Surgery Society","authors":"Rogério Aparecido Dedivitis , Mario Augusto Ferrari de Castro , Fátima Cristina Mendes de Matos , Marianne Yumi Nakai , Leandro Luongo de Matos , Marco Aurélio Vamondes Kulcsar , Carlos Takahiro Chone , Luiz Paulo Kowalski , Fernando Luiz Dias , André Cruz Martins , Bruna Carteiro Silva","doi":"10.1016/j.bjorl.2025.101710","DOIUrl":"10.1016/j.bjorl.2025.101710","url":null,"abstract":"<div><h3>Objectives</h3><div>To standardize the necessary competencies for Head and Neck Surgery residents related to the specialty.</div></div><div><h3>Methods</h3><div>The Delphi process was employed in its sequential phases: the selection of an expert panel; a structured questionnaire containing a preliminary list of potential competencies; the electronic distribution of the questionnaire to the experts, with options to “maintain”, “remove”, or “modify” the competencies and to suggest the inclusion of new competencies; a second round indicating “agree” or “disagree” for each reformulated or new competency; and the final consensus.</div></div><div><h3>Results</h3><div>Forty-six competencies were established for Head and Neck Surgery residents in the specialty.</div></div><div><h3>Conclusion</h3><div>Head and Neck Surgery residents and fellows should be trained in depth for the competency framework encompassing both routine and complex surgical interventions.</div></div><div><h3>Level of evidence</h3><div>5.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101710"},"PeriodicalIF":1.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050377","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}
Pub Date : 2025-09-11DOI: 10.1016/j.bjorl.2025.101716
Gustavo Polacow Korn , Michal M. Johns III
{"title":"The emerging role of platelet-rich plasma subepithelial infusion for vocal fold scar, sulcus, and atrophy","authors":"Gustavo Polacow Korn , Michal M. Johns III","doi":"10.1016/j.bjorl.2025.101716","DOIUrl":"10.1016/j.bjorl.2025.101716","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101716"},"PeriodicalIF":1.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-11DOI: 10.1016/j.bjorl.2025.101714
Alexandre Vallée
{"title":"Generative artificial intelligence in otorhinolaryngology: From innovation to public health transformation","authors":"Alexandre Vallée","doi":"10.1016/j.bjorl.2025.101714","DOIUrl":"10.1016/j.bjorl.2025.101714","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101714"},"PeriodicalIF":1.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-10DOI: 10.1016/j.bjorl.2025.101705
Bo Li , Cuiping She
Objective
The levels of vitamin D in the human body are primarily measured through serum 25-hydroxyvitamin D (25(OH)D) levels. Observational studies suggest a potential association between the incidence of laryngeal cancer and vitamin D levels, but the causality remains unclear. This study aims to investigate the potential causal relationship between vitamin D levels and laryngeal cancer.
Methods
This Mendelian Randomization (MR) study is based on large-scale GWAS (Genome-Wide Association Study) summary datasets. We selected two different datasets of 25(OH)D and conducted two two-sample univariable Mendelian Randomization (MR) analyses. Four different MR methods were applied, and a series of sensitivity analyses were performed. In addition, a two-sample Mendelian randomization was conducted to account for the confounding effect of smoking. Furthermore, we performed GO enrichment analyses on the SNPs used as instrumental variables.
Results
The combined findings from both univariable MR analyses support a potential causal relationship between serum 25(OH)D levels and laryngeal cancer, suggesting that higher levels of vitamin D may have a protective effect against laryngeal cancer. Multivariable MR analysis showed that even after accounting for smoking as a confounding factor, the impact of 25(OH)D on laryngeal cancer remained significant. Enrichment analysis further indicated that 25(OH)D may inhibit the occurrence and progression of laryngeal cancer by regulating the metabolism of exogenous substances, lipid metabolism, and cellular responses to environmental stimuli.
Conclusion
Higher serum 25-hydroxyvitamin D levels serve as a protective factor against laryngeal cancer, suggesting that increasing vitamin D levels may reduce the risk of laryngeal cancer.
Level of evidence
This was a Mendelian randomized study with a level of evidence second only to clinical randomized trials, and higher than cohort and case-control studies.
{"title":"Causal analysis of the impact of serum 25-hydroxyvitamin D levels on laryngeal cancer: A two-sample mendelian randomization study","authors":"Bo Li , Cuiping She","doi":"10.1016/j.bjorl.2025.101705","DOIUrl":"10.1016/j.bjorl.2025.101705","url":null,"abstract":"<div><h3>Objective</h3><div>The levels of vitamin D in the human body are primarily measured through serum 25-hydroxyvitamin D (25(OH)D) levels. Observational studies suggest a potential association between the incidence of laryngeal cancer and vitamin D levels, but the causality remains unclear. This study aims to investigate the potential causal relationship between vitamin D levels and laryngeal cancer.</div></div><div><h3>Methods</h3><div>This Mendelian Randomization (MR) study is based on large-scale GWAS (Genome-Wide Association Study) summary datasets. We selected two different datasets of 25(OH)D and conducted two two-sample univariable Mendelian Randomization (MR) analyses. Four different MR methods were applied, and a series of sensitivity analyses were performed. In addition, a two-sample Mendelian randomization was conducted to account for the confounding effect of smoking. Furthermore, we performed GO enrichment analyses on the SNPs used as instrumental variables.</div></div><div><h3>Results</h3><div>The combined findings from both univariable MR analyses support a potential causal relationship between serum 25(OH)D levels and laryngeal cancer, suggesting that higher levels of vitamin D may have a protective effect against laryngeal cancer. Multivariable MR analysis showed that even after accounting for smoking as a confounding factor, the impact of 25(OH)D on laryngeal cancer remained significant. Enrichment analysis further indicated that 25(OH)D may inhibit the occurrence and progression of laryngeal cancer by regulating the metabolism of exogenous substances, lipid metabolism, and cellular responses to environmental stimuli.</div></div><div><h3>Conclusion</h3><div>Higher serum 25-hydroxyvitamin D levels serve as a protective factor against laryngeal cancer, suggesting that increasing vitamin D levels may reduce the risk of laryngeal cancer.</div></div><div><h3>Level of evidence</h3><div>This was a Mendelian randomized study with a level of evidence second only to clinical randomized trials, and higher than cohort and case-control studies.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101705"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-10DOI: 10.1016/j.bjorl.2025.101708
Maria Fernanda Di Gregorio , Ana Celeste Ferrari , Anandhan Dhanasingh , Maximo Zernotti , Mario Zernotti
Objective
Cochlear size, shape and the anatomy vary a lot among the human population. Cochlear size is a clinically useful parameter to determine the suitable cochlear implant electrode length. Objective is to assess the cochlear size and shape variation among the Argentine population.
Methods
Computer Tomography (CT) scans of 247 ears were assessed for the cochlear parameters including basal turn diameter (A-value) and width (B-value) and the cochlear height in the mid-modiolar section (H-value) using OTOPLAN® version 4.0. Shape of cochlear basal turn was determined by the ratio between B- and A-values. Cochlear Duct Length (CDL) was estimated from the A-, and B-values.
Results
The A-value was found to vary between 6.7 mm and 10.1 mm with a mean value of 8.7 ± 0.61 mm and the B-value was found to vary between 4.5 mm and 8.1 mm with a mean value of 6.4 ± 0.57 mm. The cochlear height as measured in the axial view from the mid-modiolar section was 3.78 ± 0.57 mm. Shape of the cochlear basal turn as determined by the ratio between B- and A-values showed 41 out of 248 ears (16.5%) have more of a round shaped basal turn with the ratio of ≥0.75 leaving the remaining 207 ears (83.5%) with more of an elliptical shaped basal turn. CDL was found to vary between 24.5 mm and 41.2 mm with a median value of 33.6 mm.
Conclusion
Argentine population appears to have slightly smaller cochlear size compared to population from other countries as reported in literature.
{"title":"Cochlear size variation among the Argentinian population","authors":"Maria Fernanda Di Gregorio , Ana Celeste Ferrari , Anandhan Dhanasingh , Maximo Zernotti , Mario Zernotti","doi":"10.1016/j.bjorl.2025.101708","DOIUrl":"10.1016/j.bjorl.2025.101708","url":null,"abstract":"<div><h3>Objective</h3><div>Cochlear size, shape and the anatomy vary a lot among the human population. Cochlear size is a clinically useful parameter to determine the suitable cochlear implant electrode length. Objective is to assess the cochlear size and shape variation among the Argentine population.</div></div><div><h3>Methods</h3><div>Computer Tomography (CT) scans of 247 ears were assessed for the cochlear parameters including basal turn diameter (A-value) and width (B-value) and the cochlear height in the mid-modiolar section (H-value) using OTOPLAN® version 4.0. Shape of cochlear basal turn was determined by the ratio between B- and A-values. Cochlear Duct Length (CDL) was estimated from the A-, and B-values.</div></div><div><h3>Results</h3><div>The A-value was found to vary between 6.7 mm and 10.1 mm with a mean value of 8.7 ± 0.61 mm and the B-value was found to vary between 4.5 mm and 8.1 mm with a mean value of 6.4 ± 0.57 mm. The cochlear height as measured in the axial view from the mid-modiolar section was 3.78 ± 0.57 mm. Shape of the cochlear basal turn as determined by the ratio between B- and A-values showed 41 out of 248 ears (16.5%) have more of a round shaped basal turn with the ratio of ≥0.75 leaving the remaining 207 ears (83.5%) with more of an elliptical shaped basal turn. CDL was found to vary between 24.5 mm and 41.2 mm with a median value of 33.6 mm.</div></div><div><h3>Conclusion</h3><div>Argentine population appears to have slightly smaller cochlear size compared to population from other countries as reported in literature.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101708"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-10DOI: 10.1016/j.bjorl.2025.101713
Vanessa Brito Campoy Rocha , Raquel Mezzalira , Guita Stoler , Gil Guerra-Junior , Sofia Helena Valente de Lemos-Marini , Andréa Trevas Maciel-Guerra
Objective
To perform a thorough evaluation of body balance in Turner Syndrome, adding evidence to the already scarce data in literature regarding labyrinth impairment in these patients.
Methods
Adolescent and adult patients and a control group of healthy women were subject to otolaryngological, audiological, and vestibular evaluations. The latter included electronystagmography with caloric and rotational testing, cervical vestibular-evoked myogenic potential and static posturography with dynamic tests.
Results
Twenty-seven patients aged 15–33 years (mean: 21.9-years) were evaluated. Karyotype was 45,X in 13/27 cases. Dizziness was reported in eight patients and progressive hearing loss in ten. Audiometry was abnormal in 13/27 cases, six of them sensorineural, six conductive, and one with a mixed pattern. A balance abnormality was found in 21/27 patients (78%). Nineteen patients had vestibular lesion, [12 peripheral (57%), four combined (19%), three central (11%)] and two had only somatosensorial deficit. Non-vestibular abnormalities were found in 6 (22%) patients, five with somatosensorial deficit and one with visual dependence. Balance abnormalities were neither associated with karyotype (45,X vs. other karyotypes) nor with hearing impairment. Control group comprised 20 healthy women aged 27–35 years (mean: 30.5 years); 4/20 (25%) had a balance abnormality, two peripheral and two central causes, a frequency significantly lower than that of TS patients (p < 0.001).
Conclusion
Despite the low frequency of self-reported vestibular and auditory symptoms, this study reveals a high rate of inner ear involvement among women with TS, in which both auditory and vestibular pathways are frequently affected, often in a subclinical or compensated manner. These findings reinforce the importance of comprehensive screening protocols and indicate that appropriate interventions, including vestibular rehabilitation, should be considered as components of clinical follow-up in this population.
{"title":"High frequency of balance abnormalities in Turner syndrome","authors":"Vanessa Brito Campoy Rocha , Raquel Mezzalira , Guita Stoler , Gil Guerra-Junior , Sofia Helena Valente de Lemos-Marini , Andréa Trevas Maciel-Guerra","doi":"10.1016/j.bjorl.2025.101713","DOIUrl":"10.1016/j.bjorl.2025.101713","url":null,"abstract":"<div><h3>Objective</h3><div>To perform a thorough evaluation of body balance in Turner Syndrome, adding evidence to the already scarce data in literature regarding labyrinth impairment in these patients.</div></div><div><h3>Methods</h3><div>Adolescent and adult patients and a control group of healthy women were subject to otolaryngological, audiological, and vestibular evaluations. The latter included electronystagmography with caloric and rotational testing, cervical vestibular-evoked myogenic potential and static posturography with dynamic tests.</div></div><div><h3>Results</h3><div>Twenty-seven patients aged 15–33 years (mean: 21.9-years) were evaluated. Karyotype was 45,X in 13/27 cases. Dizziness was reported in eight patients and progressive hearing loss in ten. Audiometry was abnormal in 13/27 cases, six of them sensorineural, six conductive, and one with a mixed pattern. A balance abnormality was found in 21/27 patients (78%). Nineteen patients had vestibular lesion, [12 peripheral (57%), four combined (19%), three central (11%)] and two had only somatosensorial deficit. Non-vestibular abnormalities were found in 6 (22%) patients, five with somatosensorial deficit and one with visual dependence. Balance abnormalities were neither associated with karyotype (45,X vs. other karyotypes) nor with hearing impairment. Control group comprised 20 healthy women aged 27–35 years (mean: 30.5 years); 4/20 (25%) had a balance abnormality, two peripheral and two central causes, a frequency significantly lower than that of TS patients (p < 0.001).</div></div><div><h3>Conclusion</h3><div>Despite the low frequency of self-reported vestibular and auditory symptoms, this study reveals a high rate of inner ear involvement among women with TS, in which both auditory and vestibular pathways are frequently affected, often in a subclinical or compensated manner. These findings reinforce the importance of comprehensive screening protocols and indicate that appropriate interventions, including vestibular rehabilitation, should be considered as components of clinical follow-up in this population.</div></div><div><h3>Level of Evidence</h3><div>4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101713"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-06DOI: 10.1016/j.bjorl.2025.101704
Otávio Marana Mieli , Fabiana Cardoso Pereira Valera , Vanessa Ramos Pires Dinarte , Clara Mônica Figueiredo de Lima , Marcio Nakanishi , Maria Eduarda Trocoli Zanetti , Felipe Oliveira Pires , Denny Marcos Garcia , Adriana de Andrade Batista Murashima , Luisa Karla de Paula Arruda , Fabrizio Ricci Romano , José Eduardo Seneda Lemos , Eduardo Macoto Kosugi , Eulalia Sakano , Miguel Soares Tepedino , Edwin Tamashiro , Wilma Terezinha Anselmo-Lima
Introduction
Chronic rhinosinusitis with nasal polyp (CRSwNP) is a predominant type 2 inflammatory disease, affecting the sense of smell and quality of life. Loss of smell compromises physical and emotional health, creating negative impacts and its treatment in CRSwNP is challenging.
Aim
To present the outcomes of dupilumab in olfactory function, Nasal Polyp Score (NPS) and quality of life in Brazilian patients with severe CRSwNP.
Material & methods
We selected severe type 2 CRSwNP patients from different Brazilian centers. Dupilumab was indicated after failure of optimized medical and surgical treatment. Patients were evaluated with endoscopic Nasal Polyps Score (NPS), Connecticut smell test (CCCRC) and quality of life questionnaire (SNOT-22), at baseline (T0) and at one year (T1) after dupilumab was initiated. The clinical response was classified as good or non-responsive, according to the degree of improvement at T1. Regarding disease control, patients were classified as controlled, partially controlled or uncontrolled.
Results
53 patients completed one year of treatment (19–76 years-old); 51 individuals (96.2%) had asthma and 33 had Aspirin-Exacerbated Respiratory Disease (AERD) (62.3%). Dupilumab decreased mean SNOT-22 scores from 61.9 to 16.7 points (paired t-test, t = 13.4, p < 0.0001). The median CCCRC scores improved from anosmia (0-points) to mild hyposmia (5.5-points) (Wilcoxon signed rank test, p < 0.0001). Regarding NPS, we observed a decrease from a median of 6 in T0 to 1 at T1. AERD patients showed similar responses to those with only asthma as comorbid disease. Overall, most of the patients (86.8%) showed improvement in the disease control (Bowker's Test, p < 0.0001).
Conclusions
Real-world data show that dupilumab improved NPS, smell function, and SNOT-22 scores in the Brazilian CRSwNP population. These results support the benefits of dupilumab in treating severe cases of CRSwNP.
Level of evidence
Level 3.
慢性鼻窦炎伴鼻息肉（CRSwNP）是一种主要的2型炎症性疾病，影响嗅觉和生活质量。嗅觉丧失损害身体和情绪健康，产生负面影响，CRSwNP的治疗具有挑战性。目的探讨dupilumab对巴西重度CRSwNP患者嗅觉功能、鼻息肉评分（NPS）和生活质量的影响。材料和方法我们选择了来自巴西不同中心的严重2型CRSwNP患者。在优化的内科和外科治疗失败后，使用Dupilumab。在基线（T0）和dupilumab开始治疗后1年（T1），通过内镜下鼻息肉评分（NPS）、康涅狄格嗅觉测试（CCCRC）和生活质量问卷（SNOT-22）对患者进行评估。根据T1时的改善程度，将临床反应分为良好或无反应。在疾病控制方面，将患者分为控制、部分控制和未控制。结果53例患者完成1年治疗，年龄19 ~ 76岁；51人（96.2%）患有哮喘，33人患有阿斯匹林加重呼吸系统疾病（AERD）（62.3%）。Dupilumab使SNOT-22平均评分从61.9降至16.7分（配对t检验，t = 13.4, p < 0.0001）。CCCRC评分中位数从嗅觉缺失（0分）改善到轻度低嗅觉（5.5分）（Wilcoxon sign rank检验，p < 0.0001）。关于NPS，我们观察到从T0的中位数6下降到T1的1。AERD患者表现出与仅哮喘为合并症的患者相似的反应。总体而言，大多数患者（86.8%）的疾病控制得到改善（Bowker’s Test, p < 0.0001）。真实数据显示，dupilumab可改善巴西CRSwNP人群的NPS、嗅觉功能和SNOT-22评分。这些结果支持dupilumab治疗重症CRSwNP的益处。证据等级：3级。
{"title":"One-year efficacy of Dupilumab in sense of smell, nasal polyp score and quality of life in CRSwNP patients: A real-world multicenter study in Brazil","authors":"Otávio Marana Mieli , Fabiana Cardoso Pereira Valera , Vanessa Ramos Pires Dinarte , Clara Mônica Figueiredo de Lima , Marcio Nakanishi , Maria Eduarda Trocoli Zanetti , Felipe Oliveira Pires , Denny Marcos Garcia , Adriana de Andrade Batista Murashima , Luisa Karla de Paula Arruda , Fabrizio Ricci Romano , José Eduardo Seneda Lemos , Eduardo Macoto Kosugi , Eulalia Sakano , Miguel Soares Tepedino , Edwin Tamashiro , Wilma Terezinha Anselmo-Lima","doi":"10.1016/j.bjorl.2025.101704","DOIUrl":"10.1016/j.bjorl.2025.101704","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic rhinosinusitis with nasal polyp (CRSwNP) is a predominant type 2 inflammatory disease, affecting the sense of smell and quality of life. Loss of smell compromises physical and emotional health, creating negative impacts and its treatment in CRSwNP is challenging.</div></div><div><h3>Aim</h3><div>To present the outcomes of dupilumab in olfactory function, Nasal Polyp Score (NPS) and quality of life in Brazilian patients with severe CRSwNP.</div></div><div><h3>Material & methods</h3><div>We selected severe type 2 CRSwNP patients from different Brazilian centers. Dupilumab was indicated after failure of optimized medical and surgical treatment. Patients were evaluated with endoscopic Nasal Polyps Score (NPS), Connecticut smell test (CCCRC) and quality of life questionnaire (SNOT-22), at baseline (T0) and at one year (T1) after dupilumab was initiated. The clinical response was classified as good or non-responsive, according to the degree of improvement at T1. Regarding disease control, patients were classified as controlled, partially controlled or uncontrolled.</div></div><div><h3>Results</h3><div>53 patients completed one year of treatment (19–76 years-old); 51 individuals (96.2%) had asthma and 33 had Aspirin-Exacerbated Respiratory Disease (AERD) (62.3%). Dupilumab decreased mean SNOT-22 scores from 61.9 to 16.7 points (paired <em>t</em>-test, <em>t</em> = 13.4, p < 0.0001). The median CCCRC scores improved from anosmia (0-points) to mild hyposmia (5.5-points) (Wilcoxon signed rank test, p < 0.0001). Regarding NPS, we observed a decrease from a median of 6 in T0 to 1 at T1. AERD patients showed similar responses to those with only asthma as comorbid disease. Overall, most of the patients (86.8%) showed improvement in the disease control (Bowker's Test, p < 0.0001).</div></div><div><h3>Conclusions</h3><div>Real-world data show that dupilumab improved NPS, smell function, and SNOT-22 scores in the Brazilian CRSwNP population. These results support the benefits of dupilumab in treating severe cases of CRSwNP.</div></div><div><h3>Level of evidence</h3><div>Level 3.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101704"},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-06DOI: 10.1016/j.bjorl.2025.101707
Lucas Sousa Salgado, Vinicius Domene, Thomas Peter Maahs, Rafael de Castro da Silva, Vanessa Carvalho de Oliveira, Renata Papatella Araujo, Carlos Takahiro Chone
{"title":"Endonasal endoscopic treatment of a rare advanced Teratocarcinosarcoma of skull base","authors":"Lucas Sousa Salgado, Vinicius Domene, Thomas Peter Maahs, Rafael de Castro da Silva, Vanessa Carvalho de Oliveira, Renata Papatella Araujo, Carlos Takahiro Chone","doi":"10.1016/j.bjorl.2025.101707","DOIUrl":"10.1016/j.bjorl.2025.101707","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101707"},"PeriodicalIF":1.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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