Brazilian Journal of Otorhinolaryngology最新文献_第4页

Combined endoscopic and open frontolateral laryngectomy for glottic tumors involving the anterior commissure 内窥镜联合开放额外侧喉切除术治疗声门肿瘤累及前联合

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2026-03-01 Epub Date: 2025-11-28 DOI: 10.1016/j.bjorl.2025.101742

Leonardo Haddad , Fabio Pupo Ceccon , Leticia Angélica da Silva Souza , Beatrice Haase Ceccon , João Vitor Pincelli , Mateus Morais Aires

Objective

The combined endoscopic and open frontolateral laryngectomy technique has been proposed to balance oncologic safety with functional preservation in the management of glottic tumors involving the Anterior Commissure (AC). This study aims to describe this technique in detail, its indications, and to present our institution’s case series.

Methods

A retrospective review was conducted of all patients undergoing surgery for glottic lesions suspected of malignancy between 2017 and 2024 at a single institution. Patients treated with the combined endoscopic and open frontolateral laryngectomy approach were included. Surgical technique, indications, contraindications, and perioperative management were documented. Outcomes assessed included oncologic control, tracheostomy status, and laryngeal function.

Results

Among 138 patients treated surgically for suspected malignant glottic lesions, four patients underwent the combined approach. Tumor stages included T1b (n = 2), T2 (n = 1), and T3 (n = 1). All patients were male, with a mean age of 71.5-years. Local disease control was achieved in three patients (75%), while one T3 patient experienced recurrence requiring salvage radiotherapy, achieving subsequent disease control. All patients retained laryngeal function, with no need for permanent tracheostomy or reports of dysphagia. Postoperative dysphonia was characterized by roughness, breathiness, and high-pitched but functional voices.

Conclusion

The combined approach offers a feasible alternative for managing AC-involving glottic tumors, providing oncologic safety while preserving function. It enables precise tumor resection with limited sacrifice of normal tissue and the potential for phonation-preserving reconstruction. Given the small sample size, further studies are needed to validate its efficacy and long-term benefits.

Level of evidence

4.

目的探讨经内镜联合开放额外侧喉切除术治疗声门前连合（AC）肿瘤时兼顾肿瘤安全性和功能保护的方法。本研究旨在详细描述该技术，其适应症，并介绍本机构的病例系列。方法回顾性分析2017年至2024年在同一医院接受声门病变疑似恶性手术的所有患者。采用内窥镜和开放额外侧喉切除术联合入路治疗的患者包括在内。记录手术技术、适应症、禁忌症和围手术期处理。评估的结果包括肿瘤控制、气管造口状态和喉功能。结果138例疑似声门恶性病变行手术治疗的患者中，4例采用联合入路。肿瘤分期包括T1b （n = 2）、T2 （n = 1）和T3 （n = 1）。所有患者均为男性，平均年龄71.5岁。3例（75%）患者获得局部疾病控制，1例T3患者出现复发，需要补救性放疗，实现了后续疾病控制。所有患者均保留喉功能，无永久性气管切开术或吞咽困难报告。术后语音障碍的特征是粗糙、呼吸困难和高音调但功能正常的声音。结论联合入路是治疗ac累及声门肿瘤的可行选择，在保证功能的同时保证肿瘤的安全性。它可以精确切除肿瘤，同时限制正常组织的牺牲和保留发音重建的潜力。由于样本量小，需要进一步的研究来验证其疗效和长期效益。证据水平4。

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引用次数: 0

Genetic diagnosis of macrotia in PIK3CA-Related Overgrowth Spectrum (PROS) and long-term outcome of otoplasty: a case report and literature review pik3ca相关过度生长谱（PROS）中巨大畸形的遗传诊断和耳廓成形术的长期预后：1例报告和文献复习。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2026-03-01 Epub Date: 2026-02-05 DOI: 10.1016/j.bjorl.2026.101766

Lili Chen , Xuerui Hu , Jingwen Li , Chenlong Li , Jing Ma , Aijuan He , Yaoyao Fu , Tianyu Zhang

Objectives

PIK3CA-Related Overgrowth Spectrum (PROS) is a highly heterogeneous disease. Facial Infiltrating Lipomatosis (FIL) is a rare PROS subset, and its atypical phenotypes, such as macrotia, present diagnostic and therapeutic challenges due to limited data. This study aims to detail the diagnostic and long-term management procedures for an extremely rare case of Macrotia associated with PROS/FIL.

Methods

To confirm the underlying etiology, Whole Exome Sequencing (WES) was performed, complementing routine clinical and pathological examinations. Otoplasty was used as the intervention to reduce ear size. Long-term follow-up was conducted to monitor surgical outcome, stability, and potential recurrence.

Results

WES identified a PIK3CA pathogenic variant (p.H1047R). Combined with pathological findings, the patient was definitively diagnosed with PROS manifesting as the FIL phenotype. The reductive otoplasty surgery achieved significant improvement in the affected ear's morphology, reducing the deformity to a minimal, aesthetically pleasing level. Crucially, the 1-year follow-up showed remarkable stability in the near-normal ear contour, without any signs of recurrence or overgrowth. The successful aesthetic restoration significantly alleviated the patient's psychological distress.

Conclusions

This case demonstrates that WES is essential for accurate molecular diagnosis of PROS/FIL in patients presenting with atypical phenotypes like Macrotia. Furthermore, otoplasty is an effective and reliable reconstructive strategy for restoring ear aesthetics in these patients, providing excellent and stable long-term results and improving patient quality of life.

Level of evidence

Level 4.

目的：pik3ca相关过度生长谱（PROS）是一种高度异质性的疾病。面部浸润性脂肪瘤病（FIL）是一种罕见的PROS亚型，由于数据有限，其非典型表型（如巨大症）给诊断和治疗带来了挑战。本研究的目的是详细的诊断和长期处理程序的一个极其罕见的病例巨肌畸形与PROS/FIL。方法：在常规临床和病理检查的基础上，采用全外显子组测序（WES）确定病因。耳廓成形术是减小耳尺寸的干预手段。进行长期随访以监测手术结果、稳定性和潜在复发。结果：WES鉴定出一株PIK3CA致病变异（p.H1047R）。结合病理结果，患者明确诊断为PROS，表现为FIL表型。还原性耳廓成形术显著改善了患耳的形态，将畸形减少到最小，美观的水平。至关重要的是，1年的随访显示，在接近正常的耳廓中，稳定性显著，没有任何复发或过度生长的迹象。成功的美学修复明显减轻了患者的心理困扰。结论：本病例表明，WES对于大鼠等非典型表型患者的PROS/FIL的准确分子诊断至关重要。此外，耳廓成形术是一种有效和可靠的重建策略，可以恢复这些患者的耳美学，提供良好和稳定的长期效果，并提高患者的生活质量。证据等级：四级。

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引用次数: 0

Genetically predicted plasma metabolites mediate the relation between inflammatory factors and Meniere's disease 基因预测血浆代谢物介导炎症因子与梅尼埃病之间的关系。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2026-03-01 Epub Date: 2026-02-05 DOI: 10.1016/j.bjorl.2026.101772

Jian Wang, Jian-Dao Hu, Jing Qian

Objective

Emerging evidence suggests inflammation contributes to Meniere’s Disease (MD), a chronic vestibular disorder characterized by vertigo, hearing loss, and tinnitus. However, the causal role of Inflammatory Factors (IFs) and the mediating effects of Plasma Metabolites (PMs) in MD remain unclear. This study investigated bidirectional causality between IFs and MD and evaluated PMs as potential mediators.

Methods

Using Genome-Wide Association Study (GWAS) summary data, we performed bidirectional Mendelian Randomization (MR) analyses to assess causal links between 91 IFs, 1,400 PMs, and MD. Single Nucleotide Polymorphisms (SNPs) genome-wide significant for IFs, PMs, and MD served as instrumental variables. Inverse Variance Weighting (IVW), MR-Egger, and weighted median methods were applied. Mediation analysis quantified PMs’ role in IF-MD associations. Sensitivity analyses (MR-PRESSO, leave-one-out) tested robustness.

Results

Genetically predicted higher CCL23 levels reduced MD risk (IVW OR = 0.5757 per SD decrease; 95% CI 0.3679–0.9007; p = 0.0156). No reverse causality from MD to IFs was observed (IVW OR = 0.9919; 95% CI 0.9812–1.0028; p = 0.1448). Mediation analysis revealed PMs accounted for 14.6% of the protective effect of IFs on MD. Elevated IF levels correlated with increased PMs (IVW OR = 1.0788; 95% CI 1.0125–1.1494; p = 0.0192), while higher PMs reduced MD risk (IVW OR = 0.5444; 95% CI 0.3006–0.9859; p = 0.0448). Sensitivity analyses confirmed result consistency, with no significant pleiotropy.

Conclusion

This study identifies CCL23 as a protective factor against MD, partially mediated by PMs. Findings underscore inflammation and metabolic pathways as potential therapeutic targets. Further validation in diverse populations and exploration of biological mechanisms are needed to advance MD treatment strategies.

Level of evidence

5.

目的：新的证据表明炎症有助于梅尼埃病（MD），一种以眩晕、听力丧失和耳鸣为特征的慢性前庭疾病。然而，炎症因子（IFs）的因果作用和血浆代谢物（pm）在MD中的介导作用尚不清楚。本研究调查了IFs和MD之间的双向因果关系，并评估了pm作为潜在的介质。方法：利用全基因组关联研究（GWAS）汇总数据，我们进行了双向孟德尔随机化（MR）分析，以评估91个if、1400个pm和MD之间的因果关系。单核苷酸多态性（snp）作为工具变量，对if、pm和MD具有全基因组意义。采用反方差加权（IVW）、MR-Egger和加权中位数法。中介分析量化了pm在IF-MD关联中的作用。敏感性分析（MR-PRESSO, leave-one-out）测试了稳健性。结果：基因预测较高的CCL23水平降低了MD风险（IVW OR = 0.5757 / SD降低；95% CI 0.3679-0.9007; p = 0.0156）。未观察到MD与IFs之间的反向因果关系（IVW OR = 0.9919; 95% CI 0.9812-1.0028; p = 0.1448）。中介分析显示，干扰素对MD的保护作用占14.6%。干扰素水平升高与干扰素水平升高相关（IVW OR = 1.0788; 95% CI 1.0125-1.1494; p = 0.0192），而干扰素水平升高可降低MD风险（IVW OR = 0.5444; 95% CI 0.3006-0.9859; p = 0.0448）。敏感性分析证实了结果的一致性，没有明显的多效性。结论：本研究确定CCL23是预防MD的保护因子，部分由pm介导。研究结果强调炎症和代谢途径是潜在的治疗靶点。需要在不同人群中进一步验证和探索生物机制，以推进MD的治疗策略。证据等级：5；

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引用次数: 0

Alterations of gut microbiome in chronic rhinosinusitis: insights from a mendelian randomization study 慢性鼻窦炎患者肠道微生物组的改变：来自孟德尔随机研究的见解

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2026-01-01 Epub Date: 2025-09-20 DOI: 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":"2026-01-01","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}

引用次数: 0

Artificial intelligence, emotional intelligence, and helplessness 人工智能、情商和无助感

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2026-01-01 Epub Date: 2025-12-05 DOI: 10.1016/j.bjorl.2025.101745

Otavio B. Piltcher , Claire Hopkins

引用次数: 0

Lymphocyte-to-monocyte ratio as a clinical predictor in sudden sensorineural hearing loss 淋巴细胞/单核细胞比值作为突发性感音神经性听力损失的临床预测因子

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2026-01-01 Epub Date: 2025-11-26 DOI: 10.1016/j.bjorl.2025.101744

Elvan Onan, Ozgur Surmelioglu, Caglar Eker, Muhammed Dagkiran, Ilda Tanrisever Pehlivan, Berk Alsancak, Suleyman Ozdemir, Ozgur Tarkan, Mustafa Mete Kiroglu

Objective

This study evaluates the prognostic significance of systemic inflammatory markers ‒ NLR, LMR, PLR, and SII ‒ in patients with SSNHL.

Methods

This retrospective study included 120 patients diagnosed with SSNHL at the Otolaryngology Department of Hospital. Medical records from both SSNHL and healthy control groups were reviewed to collect demographic data, pure tone audiometry results, and routine blood parameters. Hearing recovery was assessed at baseline and after two months using Siegel's criteria, and patients were categorized as either recovered (complete, partial, or slight recovery) or unrecovered.

Results

Compared to controls, SSNHL patients showed significantly elevated neutrophil counts, platelet levels, NLR, PLR, and SII values. Statistically significant differences were observed between recovered and unrecovered groups in neutrophil count (p = 0.021), lymphocyte count (p = 0.001), PDW (p = 0.042), NLR (p = 0.001), PLR (p = 0.001), LMR (p = 0.001), and SII (p = 0.001). Logistic regression analysis identified low LMR as a significant independent predictor of poor prognosis (R² = 0.271).

Conclusion

Elevated NLR, PLR, and SII values may reflect inflammatory processes and microvascular dysfunction in SSNHL. Among these, LMR emerged as a novel and potentially valuable prognostic biomarker for predicting treatment outcomes.

Level of evidence

3.

目的评价全身炎症标志物NLR、LMR、PLR和SII在SSNHL患者中的预后意义。方法回顾性分析我院耳鼻喉科收治的120例SSNHL患者。对SSNHL组和健康对照组的医疗记录进行回顾，收集人口统计数据、纯音听力学结果和常规血液参数。在基线和两个月后使用Siegel标准评估听力恢复情况，并将患者分为完全恢复、部分恢复或轻微恢复或未恢复。结果与对照组相比，SSNHL患者中性粒细胞计数、血小板水平、NLR、PLR和SII值显著升高。恢复组与未恢复组中性粒细胞计数（p = 0.021）、淋巴细胞计数（p = 0.001）、PDW （p = 0.042）、NLR （p = 0.001）、PLR （p = 0.001）、LMR （p = 0.001）、SII （p = 0.001）差异有统计学意义。Logistic回归分析发现低LMR是不良预后的重要独立预测因子（R²= 0.271）。结论NLR、PLR和SII值升高可能反映SSNHL的炎症过程和微血管功能障碍。其中，LMR成为预测治疗结果的一种新颖且具有潜在价值的预后生物标志物。证据水平3。

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引用次数: 0

Expectations Questionnaire for Adults with Cochlear Implants (EQA-CI): Translation, adaptation and cross-cultural validation to Brazilian Portuguese 人工耳蜗植入成人期望问卷（EQA-CI）：巴西葡萄牙语的翻译、改编和跨文化验证

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2026-01-01 Epub Date: 2025-09-26 DOI: 10.1016/j.bjorl.2025.101717

Ingrid Barros Da Silva Santana , Fernanda Ferreira Caldas , Carolina Costa Cardoso , Francisco Wallison Lucena da Silva , Rayssa Pacheco Brito Dourado , Fayez Bahmad Jr

Objective

To translate, culturally adapt and validate the Cuestionário de Expectativas (CEA) for the Brazilian context, with focus on assessing the expectations of patients during pre-surgical stage.

Methods

An analytical and descriptive study was carried out, including translation, back-translation, adaptation and validation of the CEA. The process involved 119 participants who answered the questionnaire, allowing the analysis of understanding of the items using the Content Validity Index (CVI) and Exploratory Factor Analysis (EFA). Reliability was assessed with Cronbach's Alpha, McDonald's Omega and Composite Reliability coefficients, using Item Response Theory (IRT).

Results

The questionnaire had a total CVI of 0.974, indicating good comprehension by the participants, as well as high values for three internal consistency coefficients (⍺ = 0.828; ω = 0.854; CC = 0.900). The instrument showed great consistency indices and validity measures to be applied on a large scale.

Conclusion

The validity and reliability of the instrument were confirmed. Therefore, the instrument was translated, adapted and validated for Brazilian Portuguese.

Levels of evidence

Step 2.

目的翻译、文化适应和验证巴西情况下的Cuestionário de Expectativas (CEA)，重点评估术前患者的期望。方法对CEA进行翻译、反译、改编和验证等分析性和描述性研究。该过程涉及119名回答问卷的参与者，允许使用内容效度指数（CVI）和探索性因素分析（EFA）来分析对项目的理解。信度评估采用Cronbach's Alpha、McDonald's Omega和复合信度系数，采用项目反应理论（IRT）。结果问卷总CVI为0.974，表明被试理解程度较好，三个内部一致性系数（ω = 0.854, CC = 0.900）均较高。该仪器具有较好的一致性指标和有效性指标，适合大规模应用。结论证实了该仪器的有效性和可靠性。因此，该工具被翻译，改编和验证为巴西葡萄牙语。2.证据级别

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引用次数: 0

Analysis on the plane and mechanism of tongue-originated obstruction in Obstructive Sleep Apnea Syndrome (OSAS) patients with macroglossia 阻塞性睡眠呼吸暂停综合征（OSAS）伴大舌障碍患者舌源性梗阻的平面及机制分析

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2026-01-01 Epub Date: 2025-09-13 DOI: 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.

Level of evidence

IV: Retrospective cohort study.

目的应用咽磁共振成像（MRI）联合上气道压力监测（UAPM）技术，探讨阻塞性睡眠呼吸暂停综合征（OSAS）伴大舌音患者舌源性梗阻的平面及相关机制。方法选择19例OSAS伴大语言缺失患者和19例健康对照。所有病例均行咽部MRI及多导睡眠图（PSG）检查。在正中矢状面测量最小腭后间距（RP）、最小舌后间距（RL）、软腭厚度和舌背至软腭的最小间距（TP）。仅在OSAS组测量UAPM。对两组结果的差异进行统计学分析。结果UAPM和咽部MRI提示osaas患者沿腭咽平面存在梗阻面。本研究中OSAS患者的RP均值和RP/RL均显著小于对照组（p < 0.05）。两组患者RL、软腭厚度差异无统计学意义（p > 0.05）。两组TP值均接近于0，组间差异无统计学意义（p > 0.05）。结论腭咽平面是osaas伴大舌音患者最常见的梗阻性病因。相关的机制被怀疑包括由高弓引起的软腭向后运动和肥厚舌中部的下降。这些发现可以为伴有大舌症的OSAS患者的舌相关手术部位决策提供参考。证据水平iv：回顾性队列研究。

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引用次数: 0

Causal analysis of the impact of serum 25-hydroxyvitamin D levels on laryngeal cancer: A two-sample mendelian randomization study 血清25-羟基维生素D水平对喉癌影响的因果分析：一项双样本孟德尔随机化研究。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2026-01-01 Epub Date: 2025-09-10 DOI: 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.

目的：测定人体内维生素D水平主要是通过血清25-羟基维生素D （25(OH)D）水平。观察性研究表明喉癌发病率与维生素D水平之间存在潜在联系，但因果关系尚不清楚。本研究旨在探讨维生素D水平与喉癌之间的潜在因果关系。方法：这项孟德尔随机化（MR）研究基于大规模GWAS（全基因组关联研究）汇总数据集。我们选择了两个不同的25(OH)D数据集，并进行了两次双样本单变量孟德尔随机化（MR）分析。采用了四种不同的MR方法，并进行了一系列敏感性分析。此外，还进行了双样本孟德尔随机化，以解释吸烟的混杂效应。此外，我们对作为工具变量的SNPs进行了氧化石墨烯富集分析。结果：两项单变量磁共振分析的综合结果支持血清25(OH)D水平与喉癌之间的潜在因果关系，表明较高水平的维生素D可能对喉癌有保护作用。多变量磁共振分析显示，即使将吸烟作为一个混杂因素考虑在内，25(OH)D对喉癌的影响仍然显著。富集分析进一步表明，25(OH)D可能通过调节外源物质代谢、脂质代谢和细胞对环境刺激的反应来抑制喉癌的发生和发展。结论：血清25-羟基维生素D水平升高是预防喉癌的保护因素，提示维生素D水平升高可降低喉癌的发病风险。证据水平：这是一项孟德尔随机研究，证据水平仅次于临床随机试验，高于队列研究和病例对照研究。

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引用次数: 0

Otoprotective effect of the use of antioxidants on noise exposure in experimental studies with rodents – A systematic review with meta-analysis 在啮齿类动物的实验研究中，抗氧化剂对噪声暴露的耳保护作用-一项系统综述和荟萃分析

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2026-01-01 Epub Date: 2025-09-26 DOI: 10.1016/j.bjorl.2025.101696

Gabriela Guenther Ribeiro Novanta , Ana Carolina Odorizzi Zica , Maria Luiza Queiroz Sampaio , Camila de Castro Corrêa , Lucieny Silva Martins Serra , Andre Luiz Lopes Sampaio

Objective

To determine the occurrence of otoprotective effect of the use of antioxidants on noise exposure in experimental models with rodents through a systematic review.

Methods

An electronic search was conducted in EMBASE, LILACS, PubMed/Medline, Scopus, Web of Science databases, and in the grey literature of articles published up to June 2022. In the PICO strategy, the studied population consisted of rodent animals exposed to high levels of sound pressure, the intervention consisted of the use of antioxidants, the comparison with the concomitant use of placebo and the results of audiological tests such as Evoked Otoacoustic Emissions and Brainstem Auditory Evoked Potential and the results of histological and immunohistochemical evaluations were collected as outcomes. The analysis of the numerical data was performed according to the Review Manager (Cochrane), using the mean difference as a measure of effect.

Results

35 studies were included in the qualitative synthesis and 27 in the quantitative synthesis. The analysis carried out by CAMARADES indicates that most of the included studies demonstrate methodological quality, and the SYRCLE RoB risk of bias assessment protocol revealed a high risk of bias in all eligible studies. In the analysis of the meta-analysis, the effect generated by the use of antioxidants was notorious in comparison with groups that were exposed to the same noise, without the use of antioxidant. Using the ABR responses at the most commonly used frequencies of 2,000–32,000 Hz as outcomes, it was possible to observe in all analyses an otoprotective effect caused by the use of the antioxidant.

Conclusion

This systematic review with meta-analysis demonstrated the variable otoprotective effect of the use of antioxidants on exposure to sound pressure levels in experimental studies with rodents, despite the high risk of bias and great heterogeneity of the selected studies.

Level of Evidence

1.

目的通过系统评价，探讨抗氧化剂对噪声暴露小鼠耳保护作用的发生机制。方法电子检索EMBASE、LILACS、PubMed/Medline、Scopus、Web of Science等数据库和截至2022年6月发表的灰色文献。在PICO策略中，研究人群包括暴露于高水平声压下的啮齿动物，干预包括使用抗氧化剂，与伴随使用安慰剂的比较，以及听觉测试（如诱发耳声发射和脑干听觉诱发电位）的结果以及组织学和免疫组织化学评估的结果。数值数据的分析根据Review Manager （Cochrane）进行，使用平均差异作为效果的度量。结果定性综合纳入研究35篇，定量综合纳入研究27篇。CAMARADES进行的分析表明，大多数纳入的研究都具有方法学质量，sycle RoB偏倚风险评估方案显示，所有符合条件的研究都存在高偏倚风险。在荟萃分析的分析中，使用抗氧化剂产生的效果与暴露于相同噪音但不使用抗氧化剂的组相比是臭名昭著的。使用最常用频率2000 - 32000 Hz的ABR响应作为结果，可以在所有分析中观察到使用抗氧化剂引起的耳保护作用。尽管所选研究存在较高的偏倚风险和较大的异质性，但本系统综述和荟萃分析表明，在啮齿动物实验研究中，使用抗氧化剂对暴露于声压水平的耳保护作用是可变的。证据水平

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引用次数: 0