Brazilian Journal of Otorhinolaryngology最新文献_第5页

Importance of psychological follow-up in rhinoplasty 鼻整形术中心理随访的重要性

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-09-02 DOI: 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.

方法通过在科学数据库中进行全面搜索，对文献进行了系统性综述：结果虽然异维A酸对皮肤准备有好处，但一些研究表明，在鼻整形术前连续使用异维A酸可能会影响伤口愈合，这表明手术前需要暂停一段时间。其他担忧还包括异维A酸对血药浓度的影响，会增加血液变化的风险，因此在治疗期间定期监测血液变化非常重要。使用异维A酸作为鼻整形术前准备的决定必须考虑到外科医生的经验和患者的具体特征，力求在美学效果和潜在风险之间取得平衡。整形外科医生、皮肤科医生和患者之间的合作对于确保安全有效地使用异维A酸、最大限度地发挥异维A酸的益处、同时最大限度地减少这种疗法的潜在危害至关重要。

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引用次数: 0

Development of the TP53 mutation associated hypopharyngeal squamous cell carcinoma prognostic model through bulk multi-omics sequencing and single-cell sequencing 通过批量多组学测序和单细胞测序建立与 TP53 基因突变相关的下咽鳞状细胞癌预后模型

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-09-02 DOI: 10.1016/j.bjorl.2024.101499

Ying Zhang, Yue Cui, Congfan Hao, Yingjie Li, Xinyang He, Wenhui Li, Hongyang Yu

Objective

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.

Level of evidence

Level 5.

方法从TCGA数据库下载TP53突变和转录组数据。从 GEO 数据库下载了 GSE65858、GSE41613、GSE3292、GSE31056、GSE39366 和 GSE227156 数据集的基因表达数据。采用GSEA、单变量、多变量Cox分析和LASSO分析来确定关键基因并构建预后模型。利用ROC曲线验证模型得出的OS和RFS结果。通过ggplot2、corrplot软件包和GSVA分别分析了风险评分与各种临床病理特征和免疫评分之间的关联。通过无偏聚类和SingleR细胞注释分析了单细胞测序数据。结果最初确定了两个关键基因POLD2和POLR2G，并利用这两个基因构建了预后模型。根据模型得出的风险评分，样本被分为不同的风险组，高风险组样本的预后较差。此外，风险评分与患者的淋巴转移以及 CD4+ T、CD8+ T、树突状细胞、巨噬细胞和中性粒细胞的免疫评分呈正相关。高危组和低危组之间的免疫反应也存在明显差异。单细胞测序分析结果表明，上皮细胞和巨噬细胞在 HPSCC 样本中相对较多。结论该预后模型可根据 TP53 突变情况预测 HSPCC 样本的预后，并可通过模型获得的不同风险评分预测样本的癌症特征和免疫浸润评分。

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引用次数: 0

Profile of oropharyngeal swallowing in healthy Brazilian adults and older adults 巴西健康成年人和老年人的口咽吞咽概况

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-08-31 DOI: 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.

Level of evidence

4.

目的描述对无症状的年轻人和老年人进行纤维内窥镜吞咽检查（FEES）的结果，并比较不同年龄组的结果。此外，本研究还旨在测试进食评估工具（EAT-10）是否可作为识别吞咽困难风险的工具。方法对20岁及以上无症状的吞咽困难患者样本进行前瞻性横断面观察分析，并按年龄组进行分层。研究人员填写了 EAT-10 问卷，并采用 FEES 评估口咽吞咽功能。由两名耳鼻喉科专家对唾液淤积、吞咽反射触发、吞咽顺序、残留物、穿透力和吸入等各种参数进行盲法分析。检查者之间的 FEES 参数一致性良好至极佳。EAT-10评分≥3分的样本中有7.6%（n = 14）存在吞咽困难风险，与年龄或任何FEES参数均无关联。与年轻人（11.5%；n = 20/174；p = 0.039）相比，年龄≥80 岁的人有更多残留物（50%；n = 5/10）。唾液淤积只出现在年龄≥60 岁的人身上（n = 5/39；12.8%；p = 0.027）。年龄对吞咽反射触发、吞咽顺序、穿透和吸入没有影响。4.9%的受试者（n = 9）出现穿透，0.5%的受试者（n = 1）出现吸入，各年龄组之间无统计学意义。然而，年龄≥80 岁的人残留物的发生率较高，年龄≥60 岁的人唾液淤积的发生率较高，这表明吞咽困难的风险增加或存在吞咽困难。其他 FEES 参数不受年龄影响。这些发现为了解不同年龄组吞咽的微妙动态提供了宝贵的见解，强调了在吞咽困难评估中考虑特定年龄因素的重要性。

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引用次数: 0

Investigating the efficacy of melatonin, topical sodium citrate, and multivitamin with zinc as a potential treatment for postinfectious loss of smell 研究褪黑素、局部枸橼酸钠和含锌综合维生素作为治疗感染后嗅觉丧失的潜在疗法的疗效。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-08-31 DOI: 10.1016/j.bjorl.2024.101496

Ellen Cristine Duarte Garcia , Letícia Ribeiro Rosa , Ana Caroline Rodrigues dos Santos , Gabrieli Kaori Alves Ishimatsu , Natália Medeiros Dias Lopes , Marco Aurélio Fornazieri

Objectives

Upper respiratory tract infections, including COVID-19, are associated with olfactory dysfunction and there is a need for novel therapeutic approaches. The aim of study was evaluating the effectiveness of adding melatonin, multivitamin and sodium citrate to olfactory training for the treatment of olfactory loss caused by COVID-19.

Methods

We evaluated olfactory function using University of Pennsylvania Smell Identification Test (UPSIT ®) scores and self-reported patient outcomes in post-infectious smell loss cases. We investigated the effectiveness involved olfactory training combined with sodium citrate, melatonin, and multivitamin supplements with zinc over a three-month period compared to an olfactory training alone.

Results

A total of 66 patients were included, with 33 in each group. There was no significant difference in the proportion of participants who showed improvement in UPSIT scores between the groups (OR = 1.43, 95% CI 0.43–4.8, p =  0.56). Both groups showed improvement in average test scores, but there were no significant differences in self-reported olfactory ability or discomfort with olfactory loss. Qualitative symptoms, such as parosmia and phantosmia, were reported by a similar proportion in both groups before and after the treatment (p =  0.11, p =  1, respectively).

Conclusions

Olfactory training alone and olfactory training with associated with melatonin, multivitamins and topical sodium citrate did not show significant differences in improving olfactory function in post-COVID-19 patients.

Level of evidence

3.

目的：上呼吸道感染（包括 COVID-19）与嗅觉功能障碍有关，因此需要新的治疗方法。本研究旨在评估在嗅觉训练中添加褪黑素、多种维生素和柠檬酸钠对治疗 COVID-19 引起的嗅觉丧失的效果：我们使用宾夕法尼亚大学嗅觉识别测试 (UPSIT ®) 分数和患者自我报告的结果对感染后嗅觉丧失病例的嗅觉功能进行了评估。与单独进行嗅觉训练相比，我们研究了在三个月内结合柠檬酸钠、褪黑素和多种维生素锌补充剂进行嗅觉训练的效果：共纳入 66 名患者，每组 33 人。两组在改善 UPSIT 分数的人数比例上没有明显差异（OR = 1.43，95% CI 0.43-4.8，p = 0.56）。两组参与者的平均测试分数都有所提高，但在自我报告的嗅觉能力或对嗅觉丧失的不适感方面没有显著差异。两组患者在治疗前后报告的副嗅和幻嗅等定性症状比例相似（分别为 p = 0.11 和 p = 1）：结论：单纯的嗅觉训练和与褪黑素、多种维生素和局部枸橼酸钠相关的嗅觉训练在改善COVID-19后患者的嗅觉功能方面没有显著差异：3:

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引用次数: 0

Immune reconstitution inflammatory syndrome mediated maxillary mucocele: a rare presentation 免疫重建炎症综合征介导的上颌粘液瘤：一种罕见的表现形式

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-08-31 DOI: 10.1016/j.bjorl.2024.101495

Vishwanath Gowda, Elsa Babu, Rajesh Radhakrishna Havaldar, Shilpa Mallapur

引用次数: 0

Gut microbiota, allergic rhinitis, vasomotor rhinitis, Mendelian randomization, causal association 肠道微生物群、过敏性鼻炎、血管运动性鼻炎、孟德尔随机化、因果关系。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-08-12 DOI: 10.1016/j.bjorl.2024.101491

Xitan Lin , Xiaoyan Hu , Jing Zhang , Jing Luo , Gang Qin , Liang Jiang

Objective

Continuous research on the structure and function of intestinal microecology has confirmed the association between gut microbiota and the occurrence, development, and outcome of allergic diseases. Here, we explored the genetic causality between gut microbiota and rhinitis.

Methods

We conducted a two-sample Mendelian Randomization (MR) study to investigate the genetic causal relationship between gut microbiota and allergic rhinitis and vasomotor rhinitis. Genetic variations in the human gut microbiota were obtained from the summary statistics of the MiBioGen study. Genome-wide summary statistics of rhinitis were obtained from the FinnGen consortium. The causal effect between gut microbiota and rhinitis was assessed using the inverse variance weighted, MR-Egger regression, and weighted median methods. In addition, sensitivity analyses were conducted using different methods, including maximum likelihood, simple mode, and weighted model methods.

Results

The IVW approach revealed a causal association of the genus Ruminococcus gauvreauii group with an increased risk of allergic rhinitis (IVW Odds Ratio [OR = 1.26] [1.04, 1.53], p-value = 0.01645). In addition, the genus Fusicatenibacter (IVW OR = 1.20 [1.02, 1.41], p-value = 0.02868) was causally associated with an increased risk of vasomotor rhinitis.

Conclusion

Gut microbiota belonging to different genera exert different effects on allergic rhinitis and vasomotor rhinitis, including reducing the risk of rhinitis, and increasing the risk of rhinitis. New insights into the mechanisms of underlying gut microbiota-associated rhinitis are provided.

Level of evidence

Level 5.

目的：对肠道微生态结构和功能的不断研究证实，肠道微生物群与过敏性疾病的发生、发展和结局之间存在关联。在此，我们探讨了肠道微生物群与鼻炎之间的遗传因果关系：我们进行了一项双样本孟德尔随机化（MR）研究，探讨肠道微生物群与过敏性鼻炎和血管运动性鼻炎之间的遗传因果关系。人类肠道微生物群的遗传变异来自 MiBioGen 研究的汇总统计。鼻炎的全基因组汇总统计数据来自芬兰基因联盟。使用逆方差加权法、MR-Egger 回归法和加权中位数法评估了肠道微生物群与鼻炎之间的因果效应。此外，还使用不同的方法进行了敏感性分析，包括最大似然法、简单模式法和加权模型法：结果：IVW方法显示，反刍球菌属高乌头菌群与过敏性鼻炎风险增加存在因果关系（IVW比值比[OR = 1.26] [1.04, 1.53]，P值 = 0.01645）。此外，Fusicatenibacter 属（IVW OR = 1.20 [1.02, 1.41]，p 值 = 0.02868）与血管运动性鼻炎风险增加有因果关系：结论：属于不同菌属的肠道微生物群对过敏性鼻炎和血管运动性鼻炎有不同的影响，包括降低鼻炎风险和增加鼻炎风险。这为了解肠道微生物群相关鼻炎的潜在机制提供了新的视角：证据等级：5 级。

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引用次数: 0

Walking one hour per day and the derived neutrophil-to-lymphocyte ratio are associated with outcome in palliative second-line immunotherapy for patients with recurrent and/or metastatic squamous cell carcinoma of head and neck 头颈部复发性和/或转移性鳞状细胞癌患者接受姑息性二线免疫疗法时，每天步行一小时和衍生的中性粒细胞与淋巴细胞比率与疗效有关

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-08-10 DOI: 10.1016/j.bjorl.2024.101493

Miguel Caballero-Borrego , Aida Piedra , Óscar Gallego , Antonio López-Pousa , Paola Castillo , Pilar Navarrete , Alba Prat , Juan J. Grau

Objectives

To determine whether routinary walking activity and the derived neutrophil-to-lymphocyte ratio are associated with outcomes in patients with recurrent and/or metastatic squamous cell carcinoma of head and neck.

Methods

This multicenter retrospective cohort study included 64 patients diagnosed with recurrent and/or metastatic squamous cell carcinoma of head and neck and treated with immunotherapy (Programmed Death-1 and Programmed Death-ligand-1 proteins inhibitors) at two tertiary centers. We compared a group that performed uninterrupted physical activity for 1 h per day and controls who performed no activity. The derived neutrophil-to-lymphocyte ratio was calculated as follows: [neutrophils / (leukocytes – neutrophils)]. Progression-free survival and overall survival were evaluated.

Results

We included 28 (44%) and 36 (56%) patients in the activity and non-activity groups, respectively. Patient characteristics, treatment details, and tumor Programmed Death-ligand-1 expression were not associated with either progression-free survival or overall survival. Physical activity was an independent beneficial factor for progression-free survival (p < 0.001) and overall survival (p < 0.001). By contrast, a derived neutrophil-to-lymphocyte ratio <3.5 was an independent beneficial factor for overall survival (p = 0.013), but not for progression-free survival (p = 0.328).

Conclusions

Walking one hour per day and having a high proportion of lymphocytes to neutrophiles (expressed as a low derived neutrophil-to-lymphocyte ratio) independently predict a better prognosis in patients with recurrent and/or metastatic squamous cell carcinoma of head and neck treated with immunotherapy.

Level of evidence

III.

方法这项多中心回顾性队列研究纳入了 64 名被诊断为复发性和/或转移性头颈部鳞状细胞癌并在两家三级医院接受免疫疗法（程序性死亡-1 和程序性死亡配体-1 蛋白抑制剂）治疗的患者。我们对每天进行 1 小时不间断体育锻炼的组别和不进行体育锻炼的对照组进行了比较。得出的中性粒细胞与淋巴细胞比率计算如下：[中性粒细胞/（白细胞-中性粒细胞）]。结果我们在活动组和非活动组中分别纳入了 28 名（44%）和 36 名（56%）患者。患者特征、治疗细节和肿瘤程序性死亡配体-1的表达与无进展生存期和总生存期无关。体育锻炼是无进展生存期（p < 0.001）和总生存期（p < 0.001）的独立有利因素。相比之下，中性粒细胞与淋巴细胞的比值为 3.5 是总生存期的独立有利因素（p = 0.013），但不是无进展生存期的独立有利因素（p = 0.328）。结论每天步行一小时以及淋巴细胞与中性粒细胞比例较高（表现为中性粒细胞与淋巴细胞比值较低）可独立预测接受免疫疗法治疗的复发性和/或转移性头颈部鳞状细胞癌患者的较佳预后。

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引用次数: 0

Determining the prognostic value of CRP and neutrophil lymphocyte ratio in patients hospitalized for deep neck infection 确定颈部深部感染住院患者 CRP 和中性粒细胞淋巴细胞比值的预后价值

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-08-10 DOI: 10.1016/j.bjorl.2024.101492

Recep Haydar Koç , Mehmet Akif Abakay , İbrahim Sayın

Objectives

This study aims to assess the impact of the Neutrophil/Lymphocyte Ratio (NLR) and C-Reactive Protein (CRP), both markers of systemic inflammation, on the duration of hospitalization for Deep Neck Infections (DNIs).

Methods

The research encompassed patients of all age groups admitted between January 2016 and January 2021 due to DNIs. Patient data, including demographic details, etiology, comorbidities, radiological findings, treatment specifics, laboratory results (CRP values, leukocyte counts, neutrophil counts, lymphocyte counts, NLR), culture outcomes, length of stay, complications, mortalities were retrospectively evaluated. Patients were categorized into two groups based on their hospitalization duration: less than 7-days and 7-days or more. Univariate and multivariate analyses were conducted to examine the association between age, NLR, CRP, and hospital stay length.

Results

The study encompassed 275 patients, with a mean age of 36 ± 20.2 years. The mean hospital stay was 9.6 ± 6.6 days. Tonsillopharyngeal infections were the most common etiology (34%). Notably, in both univariate and multivariate analyses, age, NLR, and CRP values demonstrated significant (p < 0.05) predictive influence on hospitalization duration.

Conclusion

Age emerges as a determinant that affects hospital stay duration in DNIs. Moreover, NLR is proven to be comparable to CRP in predicting hospitalization length for these patients. NLR's feasibility as a cost-effective predictive marker, being conveniently derived from routine complete blood count assessments, adds to its clinical significance. This study underscores the potential value of NLR and CRP in informing patient management and care strategies for DNIs.

目的本研究旨在评估中性粒细胞/淋巴细胞比值（NLR）和C反应蛋白（CRP）这两种全身炎症标志物对深部颈部感染（DNIs）住院时间的影响。方法本研究涵盖2016年1月至2021年1月期间因深部颈部感染住院的各年龄段患者。对患者数据进行了回顾性评估，包括人口统计学细节、病因、合并症、放射学检查结果、治疗细节、实验室结果（CRP 值、白细胞计数、中性粒细胞计数、淋巴细胞计数、NLR）、培养结果、住院时间、并发症、死亡率。根据住院时间将患者分为两组：少于 7 天和 7 天或以上。通过单变量和多变量分析来研究年龄、NLR、CRP和住院时间之间的关系。平均住院时间为 9.6 ± 6.6 天。扁桃体咽部感染是最常见的病因（34%）。值得注意的是，在单变量和多变量分析中，年龄、NLR 和 CRP 值对住院时间有显著的预测影响（p < 0.05）。此外，事实证明，NLR 在预测这些患者的住院时间方面与 CRP 不相上下。NLR 可作为一种经济有效的预测指标，且可方便地从常规全血细胞计数评估中提取，因此更具有临床意义。这项研究强调了 NLR 和 CRP 在为 DNI 患者管理和护理策略提供信息方面的潜在价值。

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引用次数: 0

A prospective histopathological analysis of the inferior turbinate: which functional parts should be preserved during turbinate surgery? 下鼻甲的前瞻性组织病理学分析：鼻甲手术应保留哪些功能部位？

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-08-09 DOI: 10.1016/j.bjorl.2024.101486

Salma Saud AlSharhan , Norah Mohammad AlNafea , Mona Mohammad Ashoor , Wasan Fahad AlMarzouq , Salwa ALRashed AlHumaid , Nada Abdallah ALBahrani , Areej Manssour Al Nemer , Reem S. AlOmar , Hussain Jawad Aljubran

Objective

Inferior turbinate (IT) hypertrophy-induced chronic nasal obstruction is one of the most common problems in rhinology. However, the histopathological analysis of the hypertrophic IT is unclear. Therefore, this study aimed to identify the histological changes and the most functional areas of the IT to assist otolaryngologists with improving and modifying surgical techniques and minimizing potential complications.

Methods

This prospective, cross-sectional study was conducted to evaluate the contribution of hypertrophic IT to nasal obstruction. For the analysis, a total of 38 adult patients (IT hypertrophy group and non-IT hypertrophy [control] group) were enrolled, and 131 specimens were obtained during the surgical procedures (IT hypertrophy group, endoscopic submucosal turbinoplasty and septoplasty; non-IT hypertrophy group, septoplasty). Intraoperative samples were collected from four sites of the IT to determine the dimensions, composition, and possible pathological changes in each individual site. The samples were analyzed using light microscopy.

Results

A comparison of the four sites of the IT in the IT hypertrophy group showed that the posterior end had the highest normal epithelium percentage, and cilia count. This suggests that preserving the functional part of the IT during surgery is crucial. Furthermore, a comparison of both groups in terms of basement membrane thickness and vessel wall thickness (p = 0.005 and p = 0.03, respectively) showed significant differences.

Conclusion

Our findings can assist otolaryngologists select the most appropriate surgical procedures for IT hypertrophy. In addition, they advocate the importance of preserving the functional part of the IT during surgical intervention to achieve an efficiently working IT and avoid undesirable complications while improving the nasal airway passage.

Level of evidence

Level 3.

目的下鼻甲肥大引起的慢性鼻塞是鼻科最常见的问题之一。然而，肥大鼻甲的组织病理学分析尚不清楚。因此，本研究旨在确定肥厚 IT 的组织病理学变化和功能最强的区域，以帮助耳鼻喉科医生改进和修改手术技术，最大限度地减少潜在并发症。为了进行分析，共招募了 38 名成年患者（IT 肥厚组和非 IT 肥厚[对照]组），并在手术过程中获取了 131 份样本（IT 肥厚组，内窥镜粘膜下鼻甲成形术和鼻中隔成形术；非 IT 肥厚组，鼻中隔成形术）。术中从 IT 的四个部位采集样本，以确定每个部位的尺寸、组成和可能的病理变化。结果对 IT 肥厚组 IT 的四个部位进行比较后发现，后端正常上皮细胞百分比和纤毛数量最高。这表明在手术中保留 IT 的功能部分至关重要。此外，两组在基底膜厚度和血管壁厚度（分别为 p = 0.005 和 p = 0.03）方面的比较也显示出显著差异。此外，我们还提倡在手术干预过程中保留 IT 功能部分的重要性，以实现 IT 的有效工作，避免不良并发症，同时改善鼻腔气道通道。

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引用次数: 0

Effect of suppression of otoacoustic emissions in individuals with and without central auditory processing disorder: a systematic review 抑制耳声发射对中枢听觉处理障碍患者和非中枢听觉处理障碍患者的影响：系统综述

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2024-08-09 DOI: 10.1016/j.bjorl.2024.101485

Jéssica Dayane da Silva , Mariana de Carvalho Leal Gouveia , Laís Cristine Delgado da Hora , Leonardo Gleygson Ângelo Venancio , Lilian Ferreira Muniz

Objective

To investigate, through a systematic review of the literature, whether there are differences in the results of otoacoustic emissions suppression tests in individuals with and without central auditory processing disorder.

Methods

Searches were carried out in the scientific databases Latin American and Caribbean Health Sciences Literature, PubMed, Scientific Electronic Library Online, Web of Science, Scopus, Science Direct and Cochrane, as well as the databases of gray literature British Library, OpenGrey.eu and Object View and Interaction Design. A systematic review of the literature was carried out, with the descriptors otoacoustic emissions and auditory perceptual disorders and their synonyms, combined by the Boolean operators AND and OR. The reading of the studies was done by peers independently and in case of disagreement in the inclusion of studies, a third researcher was consulted. Original cross-sectional articles with a comparison group that suppressed transient evoked otoacoustic emissions in individuals with and without central auditory processing disorder were included.

Results

Seven studies that evaluated children aged between 7 and 14 years old were included, with methodological variability in the performance and analysis of the exam, the contralateral noise was the most used to elicit suppression. In only three studies did the group with central auditory processing disorder show lower suppression values, however the meta-analysis shows significant differences between the groups, with lower suppression values in the study groups.

Conclusion

This study points the need for a protocol that standardizes the measurement of OAE suppression and its findings, aiming to reduce the inclusion of results unrelated to the olivocochlear system.

目的通过对文献进行系统回顾，研究患有和未患有中枢听觉处理障碍的个体在进行耳声发射抑制测试时结果是否存在差异。方法在科学数据库拉丁美洲和加勒比海健康科学文献、PubMed、科学电子图书馆在线、Web of Science、Scopus、Science Direct 和 Cochrane，以及灰色文献数据库大英图书馆、OpenGrey.eu 和 Object View and Interaction Design 中进行了搜索。通过布尔运算符 AND 和 OR 结合声发射和听觉知觉障碍及其同义词，对文献进行了系统性审查。研究阅读由同行独立完成，如果在纳入研究方面出现分歧，则咨询第三位研究人员。结果共纳入了七项对 7 至 14 岁儿童进行评估的研究，这些研究在检查的表现和分析方面存在方法上的差异，对侧噪声是最常用的引起抑制的方法。只有三项研究显示中枢听觉处理障碍组的抑制值较低，但荟萃分析表明各组之间存在显著差异，研究组的抑制值较低。结论本研究指出有必要制定一项协议，对 OAE 抑制的测量及其结果进行标准化，旨在减少纳入与耳蜗系统无关的结果。

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