Brazilian Journal of Otorhinolaryngology最新文献_第5页

Prevalence and factors associated with olfactory impairment among patients with acne treated with oral isotretinoin: a cross-sectional study 口服异维A酸治疗的痤疮患者中嗅觉障碍的发生率和相关因素：一项横断面研究。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-06-28 DOI: 10.1016/j.bjorl.2024.101461

Rogério Nabor Kondo , Hélio Amante Miot , Elouise Zwirtes Frare , Ellen Cristine Duarte Garcia , Abner Hiraku Yamakami , Marco Aurélio Fornazieri

Objective

This study aimed to investigate the prevalence and factors associated with olfactory dysfunction in individuals exposed to Isotretinoin (ISO) for the treatment of acne, using the University of Pennsylvania Smell Identification Test (UPSIT®).

Methods

This cross-sectional study enrolled age and sex-matched patients with acne who were current users of oral ISO and unexposed controls without olfactory complaints. UPSIT® and a validated questionnaire (Nasal Obstruction Symptom Evaluation) were administered to evaluate nasal obstruction in patients exposed to ISO.

Results

A total of seventy patients were recruited, with 35 in the exposed group and 35 in the unexposed group, consisting of 18 males and 17 females in each group, aged from 17 to 47 years. The prevalence of olfactory dysfunction was higher in the exposed group compared to the non-exposed group (62.9% vs. 17.1%), yielding a Prevalence Ratio (PR) of 3.7 (95% CI 1.9–7.1). However, no participants were categorized as anosmia or severe hyposmia and the majority of dysfunction was mild hyposmia compared to moderate hyposmia (51.5% vs. 11.4%). Among the exposed individuals, gasoline, orange, coffee, and wood exhibited the highest rates of identification errors (≥54%). Olfactory function demonstrated a negative correlation with treatment duration (p = 0.01), cumulative dose (p = 0.02), and nasal obstruction (p = 0.02).

Conclusions

Olfactory dysfunction was more prevalent among ISO users, despite the patients being unaware of the disorder. Olfactory changes were correlated with treatment duration, cumulative dose, and nasal obstruction.

Level of evidence

Level 4.

研究目的本研究旨在使用宾夕法尼亚大学气味识别测试（UPSIT®），调查因治疗痤疮而接触异维A酸（ISO）的患者中嗅觉功能障碍的发生率和相关因素：这项横断面研究招募了年龄和性别相匹配的痤疮患者，这些患者目前正在使用口服异维A酸治疗痤疮，而未接触异维A酸治疗痤疮的对照组则没有嗅觉问题。结果：共招募了 70 名痤疮患者：共招募了 70 名患者，其中暴露组和未暴露组各 35 人，每组各有 18 名男性和 17 名女性，年龄在 17 至 47 岁之间。与未暴露组相比，暴露组的嗅觉功能障碍患病率更高（62.9% 对 17.1%），患病率比（PR）为 3.7（95% CI 1.9-7.1）。然而，没有参与者被归类为无嗅或严重嗅觉减退，与中度嗅觉减退相比，大多数功能障碍为轻度嗅觉减退（51.5% 对 11.4%）。在暴露的个体中，汽油、橙子、咖啡和木材的识别错误率最高（≥54%）。嗅觉功能与治疗时间（p = 0.01）、累积剂量（p = 0.02）和鼻阻塞（p = 0.02）呈负相关：结论：嗅觉功能障碍在 ISO 使用者中更为普遍，尽管患者并未意识到这一障碍。嗅觉变化与治疗时间、累积剂量和鼻阻塞有关：证据等级：4 级。

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引用次数: 0

Language development in children from a public cochlear implant program 公立人工耳蜗植入项目儿童的语言发展

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-06-17 DOI: 10.1016/j.bjorl.2024.101458

Objective

To evaluate the rate of loss to follow-up in a cochlear implant program from the public health system in Southern Brazil as well as the characteristics of hearing loss, sociodemographic, sociocultural and the development of oral language in children with prelingual deafness.

Methods

Retrospective cohort study with children who underwent CI surgery between 2010 and 2020. Data was collected through of interviews and review of medical records. The language development assessment was performed using the MUSS, MAIS and IT-MAIS scales. For the classification of language development, we used as parameters the values (mean ± SD) found in a previous national study. From those values, the Z-score for each patient at each hearing age (time of experience with the cochlear implant) was calculated.

Results

Of the 225 children implanted between 2010–2020, 129 were included in this study. The rate of loss to follow-up in the program was 42.6%. The mean age at first surgery was 40.5 (±16.9) months, with 77.5% of patients having received a unilateral implant. Language results below the expected for hearing age (<Z-score-1) for the MAIS score were found in 59.7% of the sample, while for the MUSS score the proportion was 62%.

Conclusions

Most patients had an elevated mean age at cochlear implantation and there was a high rate of loss to follow-up and low attendance to speech and programming sessions. An overall poor language performance was found for this pediatric cochlear implant program from the public health system in Southern Brazil.

Level of evidence

Level 3 (Non-randomized cohort study).

目的评估巴西南部公共卫生系统人工耳蜗植入项目的随访损失率，以及语前聋儿童的听力损失特征、社会人口学、社会文化和口语发展情况。方法对 2010 年至 2020 年间接受人工耳蜗植入手术的儿童进行回顾性队列研究。通过访谈和查阅病历收集数据。语言发展评估采用 MUSS、MAIS 和 IT-MAIS 量表进行。在对语言发展进行分类时，我们使用了之前一项全国性研究中发现的数值（平均值±标度）作为参数。结果在 2010-2020 年间植入人工耳蜗的 225 名儿童中，有 129 名被纳入本研究。该计划的随访损失率为 42.6%。首次手术的平均年龄为 40.5 (±16.9) 个月，77.5% 的患者接受了单侧植入。59.7%的样本在 MAIS 评分方面的语言成绩低于预期听力年龄（Z-score-1），而在 MUSS 评分方面，这一比例为 62%。巴西南部公共卫生系统的这项儿科人工耳蜗植入计划的总体语言表达能力较差。

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引用次数: 0

Comprehensive analysis and treatment of intraoral thyroglossal duct cysts with intraoperative techniques: a 7-case series review in a tertiary care center 利用术中技术全面分析和治疗口腔内甲状舌管囊肿：一家三级医疗中心的 7 例系列回顾报告

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-06-13 DOI: 10.1016/j.bjorl.2024.101460

Bo Li , Cuiping She , Delong Liu

Objective

Intraoral thyroglossal duct cyst is a relatively rare clinical disease. This article reviews the diagnosis and treatment process of 7 patients and explores the clinical characteristics of diagnosis and treatment of intraoral thyroglossal duct cyst in combination with past literature reports.

Method

A retrospective analysis was conducted on 7 cases of intraoral thyroglossal duct cyst admitted to the Otolaryngology ward of Dalian Municipal Central Hospital from January 2017 to January 2024. The cases were recorded in terms of gender, age, symptoms, physical signs, radiological examinations, surgical methods, and postoperative complications. All cases were followed up, and the latest follow-up results were recorded.

Results

Among the 7 cases, 6 patients underwent laryngoscopic and radiological examinations before surgery, and 1 child was found to have a cyst during surgery. All cases were diagnosed with intraoral thyroglossal duct cyst and treated with plasma radiofrequency surgery. None of the patients had postoperative complications, and no recurrence was found in the six-month follow-up after discharge.

Conclusion

Intraoral thyroglossal duct cyst is rare in clinical practice. It is important to pay attention to its differential diagnosis clinically, and careful review of images is required before surgery. Cryoablation with low-temperature plasma radiofrequency is not only minimally invasive and has a quick recovery but also has few complications and a low recurrence rate. It is a safe and effective treatment method that is worthy of clinical promotion.

Level of Evidence

Level 3.

摘要】目的口内甲状舌管囊肿是临床上比较少见的疾病。本文回顾性分析了7例患者的诊治过程，并结合既往文献报道，探讨了口内甲状舌管囊肿诊治的临床特点。方法对大连市中心医院耳鼻喉科病房2017年1月-2024年1月收治的7例口内甲状舌管囊肿患者进行回顾性分析。记录病例的性别、年龄、症状、体征、影像学检查、手术方式、术后并发症等。所有病例均进行了随访，并记录了最新的随访结果。结果7例病例中，6例患者术前进行了喉镜和放射学检查，1例患儿术中发现囊肿。所有病例均被确诊为口内甲状舌管囊肿，并接受了等离子射频手术治疗。结论口内甲状舌管囊肿在临床上较为罕见。结论口内甲状舌管囊肿在临床上较为罕见，临床上应注意其鉴别诊断，手术前应仔细复查图像。低温等离子射频低温消融术不仅创伤小、恢复快，而且并发症少、复发率低。是一种安全有效的治疗方法，值得临床推广。

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引用次数: 0

Parapharyngeal and maxillary metastasis in hepatocellular carcinoma as the first presentation: a rare case 肝癌首次出现咽旁和上颌骨转移：一个罕见病例

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-06-13 DOI: 10.1016/j.bjorl.2024.101459

Shan Chen , Hua Cai , Bei-Bei Gao , Wen-Wen Wang

引用次数: 0

Sonographic characteristics and clinical characteristics combined with nomogram for predicting the aggressiveness of papillary thyroid carcinoma coexisted with Hashimoto’s thyroiditis 声像图特征和临床特征结合提名图预测甲状腺乳头状癌合并桥本氏甲状腺炎的侵袭性

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-06-10 DOI: 10.1016/j.bjorl.2024.101456

Shuangshuang Zhao , Zheng Zhang , Xin Zhang, Xincai Wu, Yanwei Chen, Xin Min, Baoding Chen

Objective

The association between Papillary Thyroid Carcinoma (PTC) and coexistent Hashimoto’s Thyroiditis (HT) was controversial. The purpose of this study was to evaluate the presence of HT exerts any influence on the aggressiveness of PTC, and to establish a nomogram for predicting the possibility of aggressiveness in PTC.

Methods

373 consecutive PTC patients with/without coexistent HT from January 2017 to December 2020 were retrospective reviewed. Patients’ clinicopathologic and sonographic characteristics were collected for univariate and multivariate analyses. A nomogram was established based on the risk factors for aggressiveness in PTC.

Results

Male (p = 0.001), tumor size >1.0 cm (p = 0.046) and lymph node metastasis (p = 0.018) were negatively associated with PTC coexisted with HT, while it was significantly positively associated with the frequence of multifocality (p = 0.010). Univariate and multivariate analyses suggested that age ≥55 years (p = 0.000), male (p = 0.027), HT (p = 0.017), tumor size >1.0 cm (p = 0.015), multifocality (p = 0.041), distance to capsular ≤0 cm (p = 0.050) and blood flow (Grade I: p = 0.044) were independent risk factors for predicting the aggressiveness in PTC. A nomogram according to these predictors was further developed and validated. The receiver operating characteristic curve (AUC = 0.734 and 0.809 for training and validation cohorts, respectively) and decision curve analyses indicated that the nomogram model was clinically useful. The calibration curve revealed that the nomogram exhibited an excellent consistency.

Conclusions

In this study, the coexistent HT might play a protective role in preventing the proliferation of PTC. Dispensable aggressive treatment may be reduced in PTC by pre-operative identification of sonographic and clinical characteristics and incorporating with the predicted nomogram model.

目的甲状腺乳头状癌（PTC）与桥本氏甲状腺炎（HT）之间的关系存在争议。本研究旨在评估桥本氏甲状腺炎的存在对 PTC 攻击性的影响，并建立预测 PTC 攻击性可能性的提名图。收集患者的临床病理和超声特征，进行单变量和多变量分析。结果男性（p = 0.001）、肿瘤大小>1.0 cm（p = 0.046）和淋巴结转移（p = 0.018）与PTC合并HT呈负相关，而与多灶性频率呈显著正相关（p = 0.010）。单变量和多变量分析表明，年龄≥55岁（p = 0.000）、男性（p = 0.027）、HT（p = 0.017）、肿瘤大小>1.0厘米（p = 0.015）、多发（p = 0.041）、与囊的距离≤0厘米（p = 0.050）和血流（I级：p = 0.044）是预测PTC侵袭性的独立危险因素。根据这些预测因素进一步绘制并验证了提名图。接受者操作特征曲线（训练队列和验证队列的 AUC 分别为 0.734 和 0.809）和决策曲线分析表明，提名图模型对临床有用。结论在这项研究中，并存的 HT 可能在防止 PTC 增殖方面起到保护作用。通过术前识别声像图和临床特征并结合预测的提名图模型，可减少对 PTC 的不必要的积极治疗。

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引用次数: 0

Orbital Apex Syndrome secondary to residual tooth root infection: a case report 继发于残留牙根感染的眶尖综合征：病例报告

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-06-10 DOI: 10.1016/j.bjorl.2024.101455

Zongxuan He , Hongyu Han , Wei Shang , Kai Song

引用次数: 0

Epidemiology, prognostic factors, and treatment of head and neck mucoepidermoid carcinoma: Analysis of the surveillance, epidemiology, and end results database 头颈部粘液表皮样癌的流行病学、预后因素和治疗：监测、流行病学和最终结果数据库分析

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-06-08 DOI: 10.1016/j.bjorl.2024.101450

Objectives

To investigate prognostic factors in patients with head and neck Mucoepidermoid Carcinoma (MEC), especially the impact of treatment modalities on survival.

Methods

Patients with primary head and neck MEC between 2000 and 2015 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Prognostic factors related to Overall Survival (OS) and Cancer-Specific Survival (CSS), as well as the impact of treatments, were evaluated by multivariable Cox regression analysis.

Results

We identified 2692 patients diagnosed with head and neck MEC, of whom 1397 (51.89%) had a parotid gland primary, 569 (22.14%) died, and 341 (12.67%) died of MEC. Older age (≥53 years), males, unmarried, lower income, tumor site in other head and neck areas, higher tumor grade, larger tumor size, and higher stage were related to poorer OS and CSS. Patients who did not undergo surgery (HR = 3.20, 95% CI 2.45‒4.18) had worse OS, while no significant difference was detected between partial and total organ excision on patients’ OS (p = 0.729). For combination therapy, patients who received radiotherapy only (HR = 3.21, 95% CI 2.27–4.53) or no surgery and no radiotherapy (HR = 2.59, 95% CI 1.83–3.67) were correlated with worse OS (vs. surgery only), but no significant difference was detected between surgery only and surgery combined with radiotherapy on patients’ OS (p = 0.218). For CSS, the corresponding results were consistent with OS.

Conclusion

Surgical resection only may be a better survival option for head and neck MEC.

目的研究头颈部黏液表皮样癌（MEC）患者的预后因素，尤其是治疗方式对生存期的影响。方法从监测、流行病学和最终结果（SEER）数据库中获取 2000 年至 2015 年间原发性头颈部黏液表皮样癌患者的资料。结果我们发现了2692名确诊为头颈部MEC的患者，其中1397人（51.89%）原发于腮腺，569人（22.14%）死亡，341人（12.67%）死于MEC。年龄较大（≥53 岁）、男性、未婚、收入较低、肿瘤部位在其他头颈部、肿瘤分级较高、肿瘤体积较大和分期较高与较差的 OS 和 CSS 有关。未接受手术的患者（HR = 3.20，95% CI 2.45-4.18）的OS较差，而部分器官切除和全器官切除对患者的OS无显著差异（P = 0.729）。就联合治疗而言，只接受放疗（HR = 3.21，95% CI 2.27-4.53）或不接受手术和放疗（HR = 2.59，95% CI 1.83-3.67）的患者OS较差（与只接受手术相比），但只接受手术和手术联合放疗对患者OS的影响无明显差异（P = 0.218）。结论仅进行手术切除可能是头颈部 MEC 患者更好的生存选择。

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引用次数: 0

Vascular vertigo and dizziness: managing and treating outpatients 血管性眩晕和头晕：门诊病人的管理和治疗

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-06-06 DOI: 10.1016/j.bjorl.2024.101453

Arlindo Cardoso Lima Neto, Roseli Saraiva Moreira Bittar

Objective

Due the lack of data on the treatment of Vascular Vertigo and Dizziness, this study aimed to report how we managed and treated those outpatients according to the recently introduced American Heart Association and Stroke Association guidelines.

Methods

We conducted a longitudinal case series from May 2022 to February 2023. We included patients who met the Bárány Society’s Vascular Vertigo and Dizziness classification and were eligible for therapy in accordance with the American Heart Association and Stroke Association guidelines, featuring aspects of the stroke group and transient attack group.

Results

Overall, 41 patients (51.2% female; median age 72 years) were enrolled; 10 (24.3%) had ischemic strokes, 30 (73.1%) had transient ischemic attack, and 1 (2.4%) had a probable isolated labyrinthine infarction. The patients received dual antiplatelet (48.7%), single antiplatelet therapy (48.7%), and anticoagulant therapy (2.4%). No new crises occurred in 95.2% of the patients, and the transient ischemic attack group showed a significant decrease in discomfort from imbalance on the visual analog scale.

Conclusions

Antiplatelets and anticoagulants are safe and effective in treating Vascular Vertigo and Dizziness as they prevent new ischemic events and increase the flow of the posterior circulation, reducing vertigo/dizziness attacks and imbalance complaints.

Level of evidence

4.

由于缺乏有关血管性眩晕和头晕治疗的数据，本研究旨在报告我们是如何根据最近推出的美国心脏协会和卒中协会指南对这些门诊患者进行管理和治疗的。我们纳入了符合巴拉尼协会血管性眩晕和头晕分类标准的患者，这些患者符合美国心脏协会和卒中协会指南规定的治疗条件，主要分为中风组和短暂性发作组。结果总计41名患者（51.2%为女性；中位年龄72岁）入组，其中10人（24.3%）患有缺血性中风，30人（73.1%）患有短暂性脑缺血发作，1人（2.4%）可能患有孤立性迷路梗死。患者接受了双重抗血小板疗法（48.7%）、单一抗血小板疗法（48.7%）和抗凝疗法（2.4%）。95.2%的患者没有出现新的危机，短暂性脑缺血发作组患者的视觉模拟量表显示失衡不适感显著下降。结论抗血小板药物和抗凝药物治疗血管性眩晕和头晕是安全有效的，因为它们可以预防新的缺血事件，增加后循环流量，减少眩晕/头晕发作和失衡症状。

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引用次数: 0

Treatment of congenital auricular fistula with local skin flaps: Two case reports 用局部皮瓣治疗先天性耳廓瘘管：两例报告

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-06-06 DOI: 10.1016/j.bjorl.2024.101454

Makoto Akutsu , Yuni Masuyama , Yuumi Nagashima , Satoru Fukami , Yasuhiro Tanaka , Hideki Hirabayashi , Sin-ichi Haruna

引用次数: 0

Psychometric evaluation of the Brazilian-Portuguese version of the Functional Outcome of Sleep Questionnaire 10 (FOSQ-10) in patients with obstructive apnea 阻塞性呼吸暂停患者睡眠功能结果问卷 10 (FOSQ-10) 巴西葡萄牙语版的心理计量学评估

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-06-04 DOI: 10.1016/j.bjorl.2024.101452

Ana Paula Sereni Manfredi Moreira , Elisabete Raca Romero de Oliveira , Luciane Bizari Coin de Carvalho , Roberto Celso Colacioppo , Terri Weaver , Edilson Zancanella , Agrício Nubiato Crespo

Objective

Perform the validation and psychometric evaluation of the Brazilian-Portuguese translation of the Functional Outcome of Sleep Questionnaire 10 (FOSQ10).

Materials and methods

182 patients (65 females 48.3 ± 14.4 years and 117 males 46.9 ± 12.4 years), were evaluated by sleep physicians suspected of having Obstructive Sleep Apnea, underwent polysomnography and completed the FOSQ-10 and the Epworth Sleepiness Scale. APA & NCME, 2014 was used to validate the data as the American Educational Research Association recommended.

Results

Quality indicators such as Bartlett's test of sphericity (χ² = 1108.2; gL = 45; p = 0.000010) and KMO (0.83), and adherence measures, attest to the quality of the model. The indicators TLI (0.97), CFI (0.98), and RMSEA (0.04) fall within the expected values. Using the Eigenvalue > 1 technique, two factors explain 53% and 13.3% of the variances. In the Parallel Analysis technique, a single factor explained 59.4653% of the random variance, and the Unidimensionality indicators UniCo = 0.921, ECV = 0.822, and MIREAL = 0.253, were supported. Construct Validity: reliability coefficients Cronbach’s α = 0.87, McDonald’s ordinal Omega index 0.9, and the Composite Reliability 0.891 were satisfactory.

Convergent validity

There was a significant Spearman correlation between FOSQ-10 and the Epworth Sleepiness Scale (r = 0.364 [−0.487; −0.226]).

Criterion validity

Was not possible to differentiate the groups based on the severity of AHI using FOSQ-10P.

Conclusions

The Brazilian translation of FOSQ-10 is valid and reliable for identifying significant effects of excessive daytime sleepiness in patients with Obstructive Sleep Apnea.

Level of evidence

2.

材料与方法182名患者（65名女性，48.3±14.4岁；117名男性，46.9±12.4岁）经睡眠医师评估疑似患有阻塞性睡眠呼吸暂停，接受了多导睡眠图检查，并填写了FOSQ-10和Epworth嗜睡量表。结果巴特利特球形度检验（χ2 = 1108.2; gL = 45; p = 0.000010）和 KMO（0.83）等质量指标以及依从性指标证明了模型的质量。指标 TLI（0.97）、CFI（0.98）和 RMSEA（0.04）均在预期值范围内。使用特征值 > 1 技术，两个因子分别解释了 53% 和 13.3% 的方差。在平行分析技术中，单因子解释了 59.4653%的随机方差，单维性指标 UniCo = 0.921、ECV = 0.822 和 MIREAL = 0.253 均得到支持。结构效度：Cronbach's α = 0.87、McDonald's ordinal Omega index 0.9 和 Composite Reliability 0.891 的信度系数令人满意。收敛效度：FOSQ-10 与 Epworth 嗜睡量表之间存在显著的 Spearman 相关性（r = 0.364 [-0.487; -0.226]）。结论FOSQ-10的巴西译本对于识别阻塞性睡眠呼吸暂停患者白天过度嗜睡的显著影响是有效和可靠的。

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引用次数: 0