Brazilian Journal of Otorhinolaryngology最新文献

Objective

To translate and validate the Facial Feminization Surgery Outcomes Evaluation in Brazilian Portuguese.

Methods

A standard back-translation method was applied to obtain the final Brazilian Portuguese language version. In total, 21 Brazilian native Portuguese speakers transgender women with surgical intent and 21 Brazilian native Portuguese speakers transgender women without surgical intent were included in the study. The FFSOE was administered to both groups and all patients underwent a test-retest two weeks later.

Results

The FFSOE showed a high internal consistency with Cronbach’s alpha greater than 0.8. The test-retest reliability was high with repeated measures being highly correlated in all items, except for item 3, where the difference was significant (p =  0.027).

Conclusion

The FFSOE showed reliability, internal consistency and reproducibility in the evaluations. It is easy to understand and quick to apply, making it a simple tool for pre- and post-operative assessment in facial feminization surgeries.

The Oxford 2011 Levels of Evidence

Level 4.

Objective

Methods

Results

Conclusion

Level of Evidence

Objective

To investigate the efficacy of cluster nursing intervention based on Enhanced Recovery After Surgery (ERAS) for xerostomia in chronic rhinosinusitis after nasal endoscopic surgery.

Methods

A total of 80 patients with chronic rhinosinusitis who underwent functional nasal endoscopic surgery between January 2020 and December 2021 were selected and randomly divided into a control group (n = 40) and an experimental group (n = 40). Patients in the control group were treated with general nursing, while ERAS-based cluster nursing intervention was adopted for the experimental group, in addition to general nursing. Xerostomia stage and comfort level were observed at 2 h, 6 h, 24 h and 48 h after surgery; negative emotions before and after nursing were also observed.

Results

After the intervention, the xerostomia stage and comfort level at 6, 24 and 48 after surgery were higher in the experimental group (p < 0.05). Negative emotions in the experimental group were lower after nursing (p < 0.001). The self-rating depression scale and self-rating anxiety scale scores increased after nursing in both two groups (p < 0.05).

Conclusion

Enhanced recovery after surgery-based cluster nursing intervention can alleviate xerostomia, improve patients' comfort levels, reduce their negative emotions and accelerate postoperative recovery.

Level of evidence

2.

Objectives

Allergic diseases and Meniere's disease found to have a possible link in observational study. However, the potential causal relationship between the two is unclear. Therefore, we aimed to explore the causal relationship between allergic diseases and Meniere's disease using a new data analysis technique called bidirectional Mendelian randomization study.

Method

Summary-level statistics for Meniere's disease and three allergic diseases (asthma, allergic rhinitis, eczema/dermatitis) were obtained from large-scale genome-wide association studies. The inverse variance weighted method was used as the primary measure, supplemented by MR-Egger regression and the weighted median method. To ensure the reliability of the conclusions, Cochran's Q, MR-Egger intercept, MR-PRESSO test, leave-one-out test, and MR Steiger test were used.

Results

Inverse-variance weighted method showed asthma (p = 0.008, OR = 3.908, 95% CI 1.424–10.724, adjust_p = 0.024), allergic rhinitis (p = 0.026, OR = 24.714, 95% CI 1.479–412.827, adjust_p = 0.026) and eczema/dermatitis (p = 0.019, OR = 3725.954, 95% CI 3.795 to 3,658,399.580, adjust_p = 0.029) all had a significant effect on Meniere's disease. Reverse Mendelian randomization studies have shown that Meniere's disease does not increase the risk of three allergic diseases. Sensitivity analysis showed no horizontal pleiotropy and heterogeneity for each trait.

Conclusion

Our Mendelian randomization analysis supports a positive causal relationship between three allergic diseases (asthma, allergic rhinitis, eczema/dermatitis) and Meniere's disease. This suggests that physicians should pay more attention to the Meniere's patient's allergy history and consider allergy avoidance as part of their treatment plan.

Level of evidence

Mendelian Randomized (MR) studies are second only to randomized controlled trials in terms of the level of evidence.

Objective

To report the process of translation and cross-cultural adaptation of theYale Pharyngeal Residue Severity Rating Scale into Brazilian Portuguese.

Methods

Methodological study approved by the Ethics Committee of the Institution (nº 5.166.256). The English original scale was translated into Brazilian Portuguese following suggested in the literature guidelines and recommendations after authorization from the authors of the original instrument, and involved the following reported steps of (1) Translation, (2) Synthesis of translations, (3) Determination of the applicability of the translated version 4) Back-translation, (5) Synthesis of the back-translated versions, and (6) Final synthesis. The translations and back-translations were performed by two bilingual translators. The research committee constituted three specialists who considered whether the linguistic, semantics, conceptual, idiomatic, and contextual equivalence of the translations and back-translations were. In Step 3, the raters consisted of three Speech-Language Pathologists and five ENT physicians divided into two subgroups (less than 5 years of professional expertise, and more than 5 years of professional expertise).

Results

Step 1 was carried out properly by the translators, in Step 2 the translated version was prepared after minor adjustments. In Step 3, the raters reported that they found no difficulties in applying the scale. The Cronbach's Alpha coefficient was 0.995, demonstrating high internal consistency of the instrument, and the analysis of the Intraclass Correlation Coefficient (ICC) among the eight raters was 0.994 with a confidence interval between 0.990 and 0.998, demonstrating excellent agreement, regardless of experience. The research committee judged the last to be adequate and not to require adjustments.

Conclusion

The Brazilian Portuguese version of theYale Pharyngeal Residue Severity Rating Scale is presented in this study.

This is a methodological study – No level of evidence.

Objectives

This study aims to review the current role of various ultrasonographic methods in the evaluation of the upper airway in patients with obstructive sleep apnea.

Methods

A literature review was performed on the medical databases: Pubmed, Web of Science, Scopus and Embase. After analyzing the available studies, six of them were selected for data extraction.

Results

All selected studies demonstrated that it is possible to use ultrasonography as a method of evaluating the upper airway. Studies with gray-scale ultrasound concluded that the lateral pharyngeal wall and tongue are thicker in patients with obstructive sleep apnea compared to non-apneic patients. Moreover, studies with tissue characterization ultrasound, nowadays called quantitative ultrasound, have identified unique features in obstructive sleep apnea patients: standardized backscatter ultrasonography demonstrated that this particular sound wave analysis is associated with the severity of obstructive sleep apnea. Ultrasonography with elastography shows that the electrical stimulus generated in the hypoglossal nerve results in greater stiffness on the side of the tongue that is stimulated; whereas studies show conflicting results regarding the evaluation of baseline tongue stiffness in obstructive sleep apnea patients compared to non-apneic subjects.

Conclusion

There is feasibility of different methods of ultrasonographic evaluation of the upper airway, with emphasis on ultrasonographic methods of tissue characterization, such as elastography, which proved to be a promising method of evaluating the mechanical properties of the muscles involved in the pathogenesis of obstructive sleep apnea and which require further studies for a better elucidation of its applicability.

Objectives

Percutaneous Vocal Fold Lateralization (PVFL) consists of external fixation with non-absorbable percutaneous suture of the vocal fold in a lateral position, under direct glottic visualization. The objective of this study is to determine the effectiveness of PVFL in a university pediatric hospital, as well as to describe the potential risks and complications of the surgery.

Methods

Retrospective cohort study, with data collected from electronic medical records. The study was approved by the Research Ethics Committee of the institution. Surgeries were performed with the modified Lichentenberg technique and data, and outcomes were analyzed.

Results

Six patients with Bilateral Vocal Fold Paralysis who underwent Percutaneous Vocal Fold Lateralization were evaluated. Three patients were male. The age at diagnosis ranged from 2 to 132 days (mean 10.5 days). The reason for investigating the upper airway was the presence of increased work of breathing and stridor. Five patients had a favorable clinical evolution, with spontaneous ventilation in room air and absence of stridor or ventilatory effort, without the need for tracheostomy. Surgical results in this series corroborate the findings of other similar cohorts, which showed Percutaneous Vocal Fold Lateralization as a safe and effective procedure in avoiding tracheostomy or allowing decannulation in children with Bilateral Vocal Fold Paralysis.

Conclusions

PVFL seems to be a safe and effective procedure, but it has morbidity, due to immediate, and probably late, non-serious complications. Studies with a larger number of patients, with longer follow-up and using a controlled and randomized clinical design are needed to establish the role of PVFL in the treatment of BVFP in newborns and infants.

Levels of evidence

Level 4 (step 4).

Objectives

One of the most common sensory impairments in the elderly is age-related hearing loss, and individuals with this condition have a higher risk of mild cognitive impairment than the overall aged population. The purpose of this study was to conduct a systematic review of the literature in order to evaluate the evidence supporting the hypothesis that mild cognitive impairment may be developed in patients with age-related hearing loss.

Methods

The PRISMA principles were followed when searching the databases of the China Knowledge Network, Wanfang, China Biomedical Literature Database, Pub Med, Cochrane Library, Embase, and Web of Science. Two investigators independently carried out the quality assessment, data extraction, and literature review of the eligible studies. Stata 17.0 was used to finish the statistical analysis and descriptive results.

Results

A total of 13 articles containing 2,222,036 individuals who were evaluated for demographic traits, factors associated with age-related hearing loss, vascular neurologic factors, and psychological factors were included after 2166 search records were found in the database. In patients with age-related hearing loss, eleven factors were found to be risk factors for the development of mild cognitive impairment: age (OR = 1.63; 95% CI 1.09–2.43), male (OR = 1.29; 95% CI 1.14–1.47), degree of hearing loss (OR = 1.35; 95% CI 1.03–1.75), not wearing hearing aids (OR = 1.56; 95% CI 1.37–1.79), cerebrovascular disease (OR = 1.41; 95% CI 1.17–1.69), cardiovascular disease (OR = 1.29; 95% CI 1.07–1.55), diabetes mellitus (OR = 1.28; 95% CI 1.20–1.35), head injury (OR = 1.22; 95% CI 1.13–1.33), alcohol consumption (OR = 1.28; 95% CI 1.14–1.43), and tobacco use (OR = 1.19; 95% CI 1.14–1.25), and depression (OR = 1.63; 95% CI 1.47–1.81).

Conclusion

Caregivers can customize care strategies to decrease the occurrence of mild cognitive impairment in elderly deaf patients by considering demographic traits, factors associated with age-related hearing loss, vascular-neurologic factors, and psychological factors.