The new corona virus infection, has a wide range of clinical manifestations. Fever and cough are the most common symptoms. The olfactory function may be also affected with COVID-19. In this randomized clinical trial, we wanted to evaluate the therapeutic effect of olfactory training with and without oral vitamin A for COVID-19-related olfactory dysfunction.
Methods
Patients answered to the standard Persian version of anosmia reporting tool and performed the quick smell test before and after 12 weeks and at the end of the 12 months follow up. The patients were randomly allocated to three groups; Group A treatment with olfactory training, Group B treatment with oral vitamin A and olfactory training, and Group C as control group which only underwent nasal irrigation twice a day. Patients were treated for 3 months and followed up for 12 months.
Results
Totally 90 patients were included in three groups. After interventions, 76.9% of patients in Group A, 86.7% of patients in Group B, and 26.7% of patients in Group C completely improved. The average intervention time was statistically significant in relationship with the final olfactory status of the patients in the 12 months follow-up. The olfactory training has significantly improved the smell alteration at the end of 3- and 12- months follow-up in A and B groups.
Conclusion
A three-months olfactory training is effective for improvement of COVID-19-related olfactory dysfunction. Adding daily oral vitamin A to olfactory training did not lead to better results in improving olfactory dysfunction.
Level of evidence
Step 2 (Level 2*): Randomized trial.
目的新晕病毒感染有多种临床表现。发热和咳嗽是最常见的症状。COVID-19 还可能影响嗅觉功能。在这项随机临床试验中,我们希望评估在口服或不口服维生素 A 的情况下进行嗅觉训练对 COVID-19 相关嗅觉功能障碍的治疗效果。患者被随机分配到三组:A 组接受嗅觉训练治疗,B 组接受口服维生素 A 和嗅觉训练治疗,C 组为对照组,只接受每天两次的鼻腔冲洗。结果三组共有 90 名患者。干预后,A 组 76.9% 的患者、B 组 86.7% 的患者和 C 组 26.7% 的患者病情完全好转。在 12 个月的随访中,平均干预时间与患者最终的嗅觉状况有显著的统计学关系。结论:为期三个月的嗅觉训练对改善 COVID-19 相关的嗅觉功能障碍很有效。结论为期三个月的嗅觉训练对改善 COVID-19 相关的嗅觉功能障碍有效,但在嗅觉训练的基础上增加每日口服维生素 A 并不能更好地改善嗅觉功能障碍:随机试验。
{"title":"Therapeutic effects of olfactory training and systemic vitamin A in patients with COVID-19-related olfactory dysfunction: a double-blinded randomized controlled clinical trial","authors":"Abolfazl Taheri , Maryam Naderi , Nematollah Jonaidi Jafari , Hamid Emadi Koochak , Mohsen Saberi Esfeedvajani , Reyhaneh Abolghasemi","doi":"10.1016/j.bjorl.2024.101451","DOIUrl":"10.1016/j.bjorl.2024.101451","url":null,"abstract":"<div><h3>Objectives</h3><p>The new corona virus infection, has a wide range of clinical manifestations. Fever and cough are the most common symptoms. The olfactory function may be also affected with COVID-19. In this randomized clinical trial, we wanted to evaluate the therapeutic effect of olfactory training with and without oral vitamin A for COVID-19-related olfactory dysfunction.</p></div><div><h3>Methods</h3><p>Patients answered to the standard Persian version of anosmia reporting tool and performed the quick smell test before and after 12 weeks and at the end of the 12 months follow up. The patients were randomly allocated to three groups; Group A treatment with olfactory training, Group B treatment with oral vitamin A and olfactory training, and Group C as control group which only underwent nasal irrigation twice a day. Patients were treated for 3 months and followed up for 12 months.</p></div><div><h3>Results</h3><p>Totally 90 patients were included in three groups. After interventions, 76.9% of patients in Group A, 86.7% of patients in Group B, and 26.7% of patients in Group C completely improved. The average intervention time was statistically significant in relationship with the final olfactory status of the patients in the 12 months follow-up. The olfactory training has significantly improved the smell alteration at the end of 3- and 12- months follow-up in A and B groups.</p></div><div><h3>Conclusion</h3><p>A three-months olfactory training is effective for improvement of COVID-19-related olfactory dysfunction. Adding daily oral vitamin A to olfactory training did not lead to better results in improving olfactory dysfunction.</p></div><div><h3>Level of evidence</h3><p>Step 2 (Level 2*): Randomized trial.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424000661/pdfft?md5=216e0b4704f4dbd4b3fe14a89cf4ed7a&pid=1-s2.0-S1808869424000661-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141274535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-03DOI: 10.1016/j.bjorl.2024.101449
Popova Inga , Tregub Pavel , Degtyarevskaya Tatiana , Starostina Svetlana , Shadyev Timur , Apollonova Irina , Boyko Andrey , Petrovskii Vladimir , Kozlova Anastasia , Ibrahimli Irada
Objectives
Exophytic Sinonasal Papilloma (ESP) is a benign tumor of the sinonasal tract. Complete surgical excision by endoscopic surgery is the treatment of choice. However, a high recurrence rate (36% at 5-year follow-up) is associated with this method, which may indicate the presence of microorganisms such as Human Papillomavirus (HPV). It is important to note that the standard treatment for ESP does not include antiviral drugs. In our study, we are testing the effectiveness of an interferon-containing drug in reducing recurrence and postoperative reactions in patients with ESP.
Methods
We included 78 patients aged 23–83 years with a confirmed diagnosis of ESP by rhinoscopy and nasal endoscopy and a positive PCR test for HPV in nasal scrapings. To compare the results, we divided the patients into main and control groups. The main group received recombinant human interferon after surgery, while the control group did not receive the drug. We performed a statistical analysis to compare the proportion of patients without reactive manifestations at different stages of the postoperative period, as well as to compare the proportion of patients with recurrent ESP at certain stages of observation.
Results
The introduction of recombinant human interferon accelerated the resolution of postoperative reactions and promoted the healing of the nasal mucosa after surgical removal of the ESP. We also found a statistically significant association between treatment with recombinant interferon and a reduction in the recurrence rate of ESP.
Conclusion
According to the results of the study, it was found that in the main group of patients who received rhIFN-α2b (recombinant human Interferon alpha 2b) in the postoperative period, the frequency of relapses of ESP and the time of postoperative recovery were significantly lower than in patients in the control group who did not take the drug.
{"title":"Interferon alpha-2b treatment for exophytic nasal papillomas and human papillomavirus infection","authors":"Popova Inga , Tregub Pavel , Degtyarevskaya Tatiana , Starostina Svetlana , Shadyev Timur , Apollonova Irina , Boyko Andrey , Petrovskii Vladimir , Kozlova Anastasia , Ibrahimli Irada","doi":"10.1016/j.bjorl.2024.101449","DOIUrl":"10.1016/j.bjorl.2024.101449","url":null,"abstract":"<div><h3>Objectives</h3><p>Exophytic Sinonasal Papilloma (ESP) is a benign tumor of the sinonasal tract. Complete surgical excision by endoscopic surgery is the treatment of choice. However, a high recurrence rate (36% at 5-year follow-up) is associated with this method, which may indicate the presence of microorganisms such as Human Papillomavirus (HPV). It is important to note that the standard treatment for ESP does not include antiviral drugs. In our study, we are testing the effectiveness of an interferon-containing drug in reducing recurrence and postoperative reactions in patients with ESP.</p></div><div><h3>Methods</h3><p>We included 78 patients aged 23–83 years with a confirmed diagnosis of ESP by rhinoscopy and nasal endoscopy and a positive PCR test for HPV in nasal scrapings. To compare the results, we divided the patients into main and control groups. The main group received recombinant human interferon after surgery, while the control group did not receive the drug. We performed a statistical analysis to compare the proportion of patients without reactive manifestations at different stages of the postoperative period, as well as to compare the proportion of patients with recurrent ESP at certain stages of observation.</p></div><div><h3>Results</h3><p>The introduction of recombinant human interferon accelerated the resolution of postoperative reactions and promoted the healing of the nasal mucosa after surgical removal of the ESP. We also found a statistically significant association between treatment with recombinant interferon and a reduction in the recurrence rate of ESP.</p></div><div><h3>Conclusion</h3><p>According to the results of the study, it was found that in the main group of patients who received rhIFN-α2b (recombinant human Interferon alpha 2b) in the postoperative period, the frequency of relapses of ESP and the time of postoperative recovery were significantly lower than in patients in the control group who did not take the drug.</p></div><div><h3>Level of evidence</h3><p>Cohort Study.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424000648/pdfft?md5=5c30bb04646d87e8d4d38fa70604363a&pid=1-s2.0-S1808869424000648-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141281878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1016/j.bjorl.2024.101442
Fabio Portella Gazmenga , Mariana Dalbo Contrera Toro , Fabio Lau , Arthur Jose Roque Cruz , Elaine Costa , Michael J. Marino , Eulalia Sakano
Objective
To perform the translation, cultural adaptation, and validation of the NOSE-Perf Scale to Brazilian Portuguese.
Methods
This study was divided into two stages. In the first stage, the questionnaire was submitted for translation and cultural adaptation, following the guidelines recommended by the ISPOR Task Force (International Society for Pharmacoeconomics and Outcomes Research). Then, the Brazilian Portuguese version of the NOSE-Perf scale was applied to a group with septal perforation and a control group. The group with perforation answered the questionnaire again after one month. Internal consistency, test-retest reliability, and discriminant validity were assessed.
Results
The Brazilian Portuguese version of the NOSE-Perf scale was applied to 32 participants, 16 from the group with septal perforations and 16 controls. The instrument obtained high internal consistency, with Cronbach's alpha scores of 0.986. High reliability was also obtained, with Spearman's correlation coefficient of 0.996 (p < 0.001) and the intraclass correlation coefficient of 0.965 with a 95% Confidence Interval (95% CI) of 0.886‒0.988. The NSP group obtained a mean total score of 13.8 ± 12.6 and the control group a score of 2.3 ± 1.8, with a statistical difference between the groups (p < 0.001), demonstrating good discriminant validity.
Conclusion
The Brazilian Portuguese version of the NOSE-Perf scale is a reliable and valid instrument for measuring symptoms in patients with nasal septum perforations.
Level of evidence
Level 2—Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence.
{"title":"Translation, cultural adaptation, and validation of the NOSE-Perf scale to Brazilian Portuguese","authors":"Fabio Portella Gazmenga , Mariana Dalbo Contrera Toro , Fabio Lau , Arthur Jose Roque Cruz , Elaine Costa , Michael J. Marino , Eulalia Sakano","doi":"10.1016/j.bjorl.2024.101442","DOIUrl":"10.1016/j.bjorl.2024.101442","url":null,"abstract":"<div><h3>Objective</h3><p>To perform the translation, cultural adaptation, and validation of the NOSE-Perf Scale to Brazilian Portuguese.</p></div><div><h3>Methods</h3><p>This study was divided into two stages. In the first stage, the questionnaire was submitted for translation and cultural adaptation, following the guidelines recommended by the ISPOR Task Force (International Society for Pharmacoeconomics and Outcomes Research). Then, the Brazilian Portuguese version of the NOSE-Perf scale was applied to a group with septal perforation and a control group. The group with perforation answered the questionnaire again after one month. Internal consistency, test-retest reliability, and discriminant validity were assessed.</p></div><div><h3>Results</h3><p>The Brazilian Portuguese version of the NOSE-Perf scale was applied to 32 participants, 16 from the group with septal perforations and 16 controls. The instrument obtained high internal consistency, with Cronbach's alpha scores of 0.986. High reliability was also obtained, with Spearman's correlation coefficient of 0.996 (<em>p</em> < 0.001) and the intraclass correlation coefficient of 0.965 with a 95% Confidence Interval (95% CI) of 0.886‒0.988. The NSP group obtained a mean total score of 13.8 ± 12.6 and the control group a score of 2.3 ± 1.8, with a statistical difference between the groups (<em>p</em> < 0.001), demonstrating good discriminant validity.</p></div><div><h3>Conclusion</h3><p>The Brazilian Portuguese version of the NOSE-Perf scale is a reliable and valid instrument for measuring symptoms in patients with nasal septum perforations.</p></div><div><h3>Level of evidence</h3><p>Level 2—Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424000570/pdfft?md5=7c4889d265d9d6e1a482fc27fb27c9f3&pid=1-s2.0-S1808869424000570-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141029808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-11DOI: 10.1016/j.bjorl.2024.101441
Xiang Li , Chao Wei , Xiang Gao , Jie Sun , Jianhong Yang
Objective
Dizziness or vertigo in older population frequently presents in clinical settings, yet its etiology remains elusive. The objective of this study was to delineate global trends and identify frontiers in research concerning dizziness or vertigo among older population.
Methods
We searched the research literature published from 2003 to 2022 on older population with dizziness or vertigo using two databases from the Web of Science Core Collection. A bibliometric and visualization analysis was conducted. Bibliometric tools facilitated co-authorship, co-citation, and keyword co-occurrence analyses, encompassing countries or regions, institutions, authors, journals, and references.
Results
The analysis included 1322 publications authored by 6524 individuals from 2244 institutions across 67 countries or regions, spanning 92 subject categories. A steady increase in publications was noted from 2003 to 2022. The University of Munich, Harvard University, and the University of California System emerged as leading institutions with the highest publication outputs. The United States, Germany, and China were predominant in publication counts. Eva Grill was identified as the most prolific author. Otology & Neurotology and Geriatrics & Gerontology emerged as the most prolific journal and subject category, respectively. The most prevalent keywords were “dizziness”, “vertigo”, “falls”, and “geriatric”, with “management”, “gait”, and “association” recognized as the principal research hotspots.
Conclusion
This study provides a systematic analysis of global scientific research on older population dizziness/vertigo, revealing significant advancements in understanding over the past two decades. Management, gait, and association have emerged as the primary research focuses on recent years. These findings offer valuable insights for directing current research efforts to capture prevailing trends and explore new frontiers in this field.
{"title":"Global trends in the research on older population dizziness/vertigo: a 20-year bibliometric and visualization analysis","authors":"Xiang Li , Chao Wei , Xiang Gao , Jie Sun , Jianhong Yang","doi":"10.1016/j.bjorl.2024.101441","DOIUrl":"10.1016/j.bjorl.2024.101441","url":null,"abstract":"<div><h3>Objective</h3><p>Dizziness or vertigo in older population frequently presents in clinical settings, yet its etiology remains elusive. The objective of this study was to delineate global trends and identify frontiers in research concerning dizziness or vertigo among older population.</p></div><div><h3>Methods</h3><p>We searched the research literature published from 2003 to 2022 on older population with dizziness or vertigo using two databases from the Web of Science Core Collection. A bibliometric and visualization analysis was conducted. Bibliometric tools facilitated co-authorship, co-citation, and keyword co-occurrence analyses, encompassing countries or regions, institutions, authors, journals, and references.</p></div><div><h3>Results</h3><p>The analysis included 1322 publications authored by 6524 individuals from 2244 institutions across 67 countries or regions, spanning 92 subject categories. A steady increase in publications was noted from 2003 to 2022. The University of Munich, Harvard University, and the University of California System emerged as leading institutions with the highest publication outputs. The United States, Germany, and China were predominant in publication counts. Eva Grill was identified as the most prolific author. <em>Otology & Neurotology</em> and <em>Geriatrics & Gerontology</em> emerged as the most prolific journal and subject category, respectively. The most prevalent keywords were “dizziness”, “vertigo”, “falls”, and “geriatric”, with “management”, “gait”, and “association” recognized as the principal research hotspots.</p></div><div><h3>Conclusion</h3><p>This study provides a systematic analysis of global scientific research on older population dizziness/vertigo, revealing significant advancements in understanding over the past two decades. Management, gait, and association have emerged as the primary research focuses on recent years. These findings offer valuable insights for directing current research efforts to capture prevailing trends and explore new frontiers in this field.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424000569/pdfft?md5=370dd81c2b5144d7bc3b397051fa0ea0&pid=1-s2.0-S1808869424000569-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.1016/j.bjorl.2024.101438
Tingting Lu , Qingxin Wang , Ziyan Gu , Zefang Li , Zhaojun Yan
Objective
To investigate the relative effectiveness of various Non-Invasive Treatment Techniques (NITs) in chronic tinnitus management.
Methods
We searched PubMed, Embase and Cochrane Library databases from the time of data construction to December 31, 2022. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, NITs were evaluated, including Aacceptance and commitment therapy (A), Cognitive behavioral therapy (C), Sound therapy (S), Transcranial magnetic stimulation (T), Electrical stimulation therapy (E), Virtual reality therapy (V), tinnitus Retraining therapy (R), general psychotherapy (D), and Placebo (P). The outcome indicators included the Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), Hospital Anxiety and Depression Scale-anxiety-Depression (HADS-D), Insomnia Severity Index (ISI), Visual Analogue Scales-Loudness (VAS-L), and Visual Analogue Scales-Distress (VAS-D). Statistical analysis was performed using Stata 14.0 for NMA.
Results
This systematic review and meta-analysis included 22 randomized controlled trials comprising 2,354 patients. The treatment effects varied on each scale. For THI, S (86.9%) was the most effective, whereas P (6.5%) was the worst. For TQ, C (89.5%) was the most effective, whereas D (25.4%) was the worst. For HADS-D, A (82.4%) was the most effective, whereas D (9.47%) was the worst. For ISI, A (83.2%) was the most effective, whereas R (20.6%) was the worst. For VAS-L, S (73.5%) was the most effective, whereas E (18.9%) was the worst. For VAS-D, C (84.7%) was the most effective, whereas P (18.1%) was the worst.
Conclusions
The combination of acoustics and cognitive behavioral therapy may be an effectively treat patients with chronic tinnitus.
Level of evidence
How common is the problem? Level 2.
Is this diagnostic or monitoring test accurate? (Diagnosis) Level 1.
What will happen if we do not add a therapy? (Prognosis) Level 1.
Does this intervention help? (Treatment Benefits) Level 1.
What are the COMMON harms? (Treatment Harms) Level 1.
What are the RARE harms? (Treatment Harms) Level 1.
Is this (early detection) test worthwhile? (Screening) Level 1I.
{"title":"Non-invasive treatments improve patient outcomes in chronic tinnitus: a systematic review and network meta-analysis","authors":"Tingting Lu , Qingxin Wang , Ziyan Gu , Zefang Li , Zhaojun Yan","doi":"10.1016/j.bjorl.2024.101438","DOIUrl":"10.1016/j.bjorl.2024.101438","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the relative effectiveness of various Non-Invasive Treatment Techniques (NITs) in chronic tinnitus management.</p></div><div><h3>Methods</h3><p>We searched PubMed, Embase and Cochrane Library databases from the time of data construction to December 31, 2022. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, NITs were evaluated, including Aacceptance and commitment therapy (A), Cognitive behavioral therapy (C), Sound therapy (S), Transcranial magnetic stimulation (T), Electrical stimulation therapy (E), Virtual reality therapy (V), tinnitus Retraining therapy (R), general psychotherapy (D), and Placebo (P). The outcome indicators included the Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), Hospital Anxiety and Depression Scale-anxiety-Depression (HADS-D), Insomnia Severity Index (ISI), Visual Analogue Scales-Loudness (VAS-L), and Visual Analogue Scales-Distress (VAS-D). Statistical analysis was performed using Stata 14.0 for NMA.</p></div><div><h3>Results</h3><p>This systematic review and meta-analysis included 22 randomized controlled trials comprising 2,354 patients. The treatment effects varied on each scale. For THI, S (86.9%) was the most effective, whereas P (6.5%) was the worst. For TQ, C (89.5%) was the most effective, whereas D (25.4%) was the worst. For HADS-D, A (82.4%) was the most effective, whereas D (9.47%) was the worst. For ISI, A (83.2%) was the most effective, whereas R (20.6%) was the worst. For VAS-L, S (73.5%) was the most effective, whereas E (18.9%) was the worst. For VAS-D, C (84.7%) was the most effective, whereas P (18.1%) was the worst.</p></div><div><h3>Conclusions</h3><p>The combination of acoustics and cognitive behavioral therapy may be an effectively treat patients with chronic tinnitus.</p></div><div><h3>Level of evidence</h3><p>How common is the problem? Level 2.</p><p>Is this diagnostic or monitoring test accurate? (Diagnosis) Level 1.</p><p>What will happen if we do not add a therapy? (Prognosis) Level 1.</p><p>Does this intervention help? (Treatment Benefits) Level 1.</p><p>What are the COMMON harms? (Treatment Harms) Level 1.</p><p>What are the RARE harms? (Treatment Harms) Level 1.</p><p>Is this (early detection) test worthwhile? (Screening) Level 1I.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424000533/pdfft?md5=3830716eebe6c98b22a03c92b78edfe6&pid=1-s2.0-S1808869424000533-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141050347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.1016/j.bjorl.2024.101439
Jiahui Fan , Zheng Jiang , Mailudan Ainiwaer , Rong Yu , Dengying Gu , Huiling Zhao
{"title":"Wound management for post-laryngeal transplant pharyngeal fistula: a case report","authors":"Jiahui Fan , Zheng Jiang , Mailudan Ainiwaer , Rong Yu , Dengying Gu , Huiling Zhao","doi":"10.1016/j.bjorl.2024.101439","DOIUrl":"10.1016/j.bjorl.2024.101439","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424000545/pdfft?md5=de83539a79ebe163f979043b9642b87a&pid=1-s2.0-S1808869424000545-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141028745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To describe the occurrence of post-extubation laryngitis, analyze its one-year evolution, and correlate laryngeal lesions with clinical outcomes.
Methods
Retrospective study including children up to 13 years old at a tertiary hospital between March 2020 and March 2022 with diagnosis of post-extubation laryngitis confirmed by endoscopic examination. Exclusion criteria were prior history of intubation or anatomical airway abnormalities. Medical records were reviewed to characterize patients, underlying diagnosis, laryngeal lesions, treatment, and outcomes at 12-month follow-up.
Results
The study included 38 endoscopically confirmed post-extubation laryngitis cases, corresponding to 86.4% of suspected cases. The mean age was 13.24 months, and 60.5% were male. Acute respiratory failure was the leading cause of intubation. Initial treatment was clinical, and initial diagnosis was defined by nasopharynoglaryngoscopy and/or Microlaryngoscopy and Bronchoscopy (MLB) findings. Initial diagnostic MLB was performed in 65.7% of the patients. Approximately half (53%) of the patients exhibited moderate or severe laryngeal lesions. When compared to mild cases, these patients experienced a higher rate of extubation failures (mean of 1.95 vs. 0.72, p = 0.0013), underwent more endoscopic procedures, and faced worse outcomes, such as the increased need for tracheostomy (p = 0.0001) and the development of laryngeal stenosis (p = 0.0450). Tracheostomy was performed in 14 (36.8%) children. Patients undergoing tracheostomy presented more extubation failures and longer intubation periods. Eight (21%) developed laryngeal stenosis, and 17 (58.6%) had complete resolution on follow-up.
Conclusion
Post-extubation laryngitis is a frequent diagnosis among patients with clinical symptoms or failed extubation. The severity of laryngeal lesions was linked to a less favorable prognosis observed at one-year follow-up. Otolaryngological evaluation, follow-up protocols, and increased access to therapeutic resources are essential to manage these children properly.
{"title":"Post-extubation laryngitis in children: diagnosis, management and follow-up","authors":"Elaine Costa, Débora Bressan Pazinatto, Luciahelena Prata Trevisan, Rebecca Maunsell","doi":"10.1016/j.bjorl.2024.101440","DOIUrl":"https://doi.org/10.1016/j.bjorl.2024.101440","url":null,"abstract":"<div><h3>Objectives</h3><p>To describe the occurrence of post-extubation laryngitis, analyze its one-year evolution, and correlate laryngeal lesions with clinical outcomes.</p></div><div><h3>Methods</h3><p>Retrospective study including children up to 13 years old at a tertiary hospital between March 2020 and March 2022 with diagnosis of post-extubation laryngitis confirmed by endoscopic examination. Exclusion criteria were prior history of intubation or anatomical airway abnormalities. Medical records were reviewed to characterize patients, underlying diagnosis, laryngeal lesions, treatment, and outcomes at 12-month follow-up.</p></div><div><h3>Results</h3><p>The study included 38 endoscopically confirmed post-extubation laryngitis cases, corresponding to 86.4% of suspected cases. The mean age was 13.24 months, and 60.5% were male. Acute respiratory failure was the leading cause of intubation. Initial treatment was clinical, and initial diagnosis was defined by nasopharynoglaryngoscopy and/or Microlaryngoscopy and Bronchoscopy (MLB) findings. Initial diagnostic MLB was performed in 65.7% of the patients. Approximately half (53%) of the patients exhibited moderate or severe laryngeal lesions. When compared to mild cases, these patients experienced a higher rate of extubation failures (mean of 1.95 vs. 0.72, <em>p</em> = 0.0013), underwent more endoscopic procedures, and faced worse outcomes, such as the increased need for tracheostomy (<em>p</em> = 0.0001) and the development of laryngeal stenosis (<em>p</em> = 0.0450). Tracheostomy was performed in 14 (36.8%) children. Patients undergoing tracheostomy presented more extubation failures and longer intubation periods. Eight (21%) developed laryngeal stenosis, and 17 (58.6%) had complete resolution on follow-up.</p></div><div><h3>Conclusion</h3><p>Post-extubation laryngitis is a frequent diagnosis among patients with clinical symptoms or failed extubation. The severity of laryngeal lesions was linked to a less favorable prognosis observed at one-year follow-up. Otolaryngological evaluation, follow-up protocols, and increased access to therapeutic resources are essential to manage these children properly.</p></div><div><h3>Level of evidence</h3><p>Level 4.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424000557/pdfft?md5=cf6e1ebbccdbd14f1cec6a38946cec07&pid=1-s2.0-S1808869424000557-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141095668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This narrative review explores alternative non-antibiotic antimicrobial agents for CRS management in adults.
Methods
Alternative antimicrobial agents using EPOS 2020 guidelines as reference were selected, and articles dated from 2003 to 2022 in English, Portuguese, or Spanish using PubMed and EMBASE databases. The parameters analyzed included study design, evidence level, population characteristics, CRS characteristics, interventions, outcomes, sample size, randomization, blinding, and side effects. Reviews, unrelated contexts,in vitro experiments, and duplicates were excluded.
Results
148 articles were screened; 19 articles were selected for analysis. Randomized controlled trials and cohort studies assessing non-antibiotic antimicrobial treatments for CRS were included. Xylitol demonstrated effectiveness in reducing CRS symptoms, particularly SNOT-22 scores, surpassing saline irrigation benefits. Manuka honey showed potential microbiological benefits in recalcitrant CRS, but symptomatic and endoscopic improvements remained inconclusive. Baby shampoo irrigation improved nasal mucociliary clearance and postoperative outcomes. Colloidal silver nasal irrigation showed limited efficacy in reducing CRS symptoms or endoscopic scores. Povidone-Iodine (PI) nasal irrigation yielded mixed results, with varying effects on culture negativity and SNOT-20 scores. Bacteriophage treatment exhibited promise in decreasing specific bacterial strains and cytokine levels.
Conclusion
Non-antibiotic antimicrobial therapies, including xylitol, manuka honey, baby shampoo, colloidal silver, PI, bacteriophages, lactoferrin, and carrageenan offer potential alternatives for CRS in adult patients. Xylitol, baby shampoo, and PI presented benefits in improving symptoms and nasal endoscopic scores, however, the number of studies is limited for conclusive recommendations and safety assessments. CRS management should adopt a comprehensive approach, particularly for non-infectious or immune-related cases, moving beyond antibiotics. Antibiotics should be reserved for confirmed bacterial infections. Overall, this review shows the importance of exploring non-antibiotic therapies to enhance the management of CRS.
{"title":"Non-antibiotic antimicrobial agents for chronic rhinosinusitis: a narrative review","authors":"Joao Vitor Bizinoto Caetano, Fabiana Cardoso Pereira Valera, Wilma T. Anselmo-Lima, Edwin Tamashiro","doi":"10.1016/j.bjorl.2024.101436","DOIUrl":"https://doi.org/10.1016/j.bjorl.2024.101436","url":null,"abstract":"<div><h3>Objective</h3><p>This narrative review explores alternative non-antibiotic antimicrobial agents for CRS management in adults.</p></div><div><h3>Methods</h3><p>Alternative antimicrobial agents using EPOS 2020 guidelines as reference were selected, and articles dated from 2003 to 2022 in English, Portuguese, or Spanish using PubMed and EMBASE databases. The parameters analyzed included study design, evidence level, population characteristics, CRS characteristics, interventions, outcomes, sample size, randomization, blinding, and side effects. Reviews, unrelated contexts,in vitro experiments, and duplicates were excluded.</p></div><div><h3>Results</h3><p>148 articles were screened; 19 articles were selected for analysis. Randomized controlled trials and cohort studies assessing non-antibiotic antimicrobial treatments for CRS were included. Xylitol demonstrated effectiveness in reducing CRS symptoms, particularly SNOT-22 scores, surpassing saline irrigation benefits. Manuka honey showed potential microbiological benefits in recalcitrant CRS, but symptomatic and endoscopic improvements remained inconclusive. Baby shampoo irrigation improved nasal mucociliary clearance and postoperative outcomes. Colloidal silver nasal irrigation showed limited efficacy in reducing CRS symptoms or endoscopic scores. Povidone-Iodine (PI) nasal irrigation yielded mixed results, with varying effects on culture negativity and SNOT-20 scores. Bacteriophage treatment exhibited promise in decreasing specific bacterial strains and cytokine levels.</p></div><div><h3>Conclusion</h3><p>Non-antibiotic antimicrobial therapies, including xylitol, manuka honey, baby shampoo, colloidal silver, PI, bacteriophages, lactoferrin, and carrageenan offer potential alternatives for CRS in adult patients. Xylitol, baby shampoo, and PI presented benefits in improving symptoms and nasal endoscopic scores, however, the number of studies is limited for conclusive recommendations and safety assessments. CRS management should adopt a comprehensive approach, particularly for non-infectious or immune-related cases, moving beyond antibiotics. Antibiotics should be reserved for confirmed bacterial infections. Overall, this review shows the importance of exploring non-antibiotic therapies to enhance the management of CRS.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S180886942400051X/pdfft?md5=2b766543b091b104b539daa5373dc955&pid=1-s2.0-S180886942400051X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140816214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-25DOI: 10.1016/j.bjorl.2024.101437
Lourival Mendes Bueno , Hugo Valter Lisboa Ramos , Claudiney Cândido Costa , Wilder Alves , Leandro Castro Velasco , Noemi Grigoleto De Biase
Objectives
Identifying voice handicap and voice-related quality of life in patients presenting pulmonary impairment associated with COVID-19 infection, comparing pulmonary parameters between these patients and individuals in the control group, as well as correlating pulmonary parameters to self-assessment questionnaires (IDV-10 and QVV).
Methods
Thirty-five (35) patients presenting pulmonary impairment with COVID-19 infection were herein selected and compared to 35 individuals who were not affected by COVID-19 infection. Two self-assessment questionnaires were applied (vocal handicap index and voice quality of life protocol). Maximum phonation time Forced Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) were measured and videolaryngoscopy was performed.
Results
There was statistically significant difference in scores recorded in voice self-assessment questionnaires (IDV-10 and QVV), Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) between patients with pulmonary impairment associated with COVID-19 infection and those in the control group. Correlation between PEF/PIF and scores recorded in voice self-assessment questionnaires was also observed.
Conclusion
Pulmonary impairment associated with COVID-19 infection has worsened voice handicap and voice-related quality of life in the assessed patients, as well as reduced their forced expiratory and inspiratory pressure in comparison to the control group.
{"title":"Voice handicap and voice-related quality of life in COVID-19 patients","authors":"Lourival Mendes Bueno , Hugo Valter Lisboa Ramos , Claudiney Cândido Costa , Wilder Alves , Leandro Castro Velasco , Noemi Grigoleto De Biase","doi":"10.1016/j.bjorl.2024.101437","DOIUrl":"10.1016/j.bjorl.2024.101437","url":null,"abstract":"<div><h3>Objectives</h3><p>Identifying voice handicap and voice-related quality of life in patients presenting pulmonary impairment associated with COVID-19 infection, comparing pulmonary parameters between these patients and individuals in the control group, as well as correlating pulmonary parameters to self-assessment questionnaires (IDV-10 and QVV).</p></div><div><h3>Methods</h3><p>Thirty-five (35) patients presenting pulmonary impairment with COVID-19 infection were herein selected and compared to 35 individuals who were not affected by COVID-19 infection. Two self-assessment questionnaires were applied (vocal handicap index and voice quality of life protocol). Maximum phonation time Forced Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) were measured and videolaryngoscopy was performed.</p></div><div><h3>Results</h3><p>There was statistically significant difference in scores recorded in voice self-assessment questionnaires (IDV-10 and QVV), Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) between patients with pulmonary impairment associated with COVID-19 infection and those in the control group. Correlation between PEF/PIF and scores recorded in voice self-assessment questionnaires was also observed.</p></div><div><h3>Conclusion</h3><p>Pulmonary impairment associated with COVID-19 infection has worsened voice handicap and voice-related quality of life in the assessed patients, as well as reduced their forced expiratory and inspiratory pressure in comparison to the control group.</p></div><div><h3>Level of evidence</h3><p>4.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424000521/pdfft?md5=5e34e439910e2b10751e6c4de7001183&pid=1-s2.0-S1808869424000521-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140796343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose was to explore the effects of traditional and non-traditional lipid parameters on Sudden Sensorineural Hearing Loss (SSNHL).
Methods
The study included 452 patients diagnosed with SSNHL, among whom 206 patients had a level of hearing improvement ≥10 dB after one month of follow-up. A propensity score-matched (2:1) control group was used. Conditional and unconditional logistic regression were used to analyze the risk factors for SSNHL.
Results
Patients with SSNHL had a higher risk of concomitant hypertension and elevated atherosclerogenic lipid levels, with apolipoprotein B and apolipoprotein E identified as independent risk factors for the onset of SSNHL. Additionally, the Lipid Comprehensive Index (LCI) was an independent risk factor for the degree of hearing loss. A positive linear correlation was revealed between triglyceride, non-high-density lipoprotein cholesterol, atherogenic index, Castelli risk index, atherogenic index of plasma, LCI and hearing loss. However, no linear relationship was observed between hearing gain and any lipid parameters. When Total Cholesterol (TC) was in the range of borderline high, the treatment effect was the best. However, the statistical significance disappeared upon adjusting for confounding factors.
Conclusion
Patients with SSNHL exhibited markedly dysregulated lipid metabolism. Elevated serum lipid levels may be a causative factor in auditory impairment and can influence the extent of hearing loss. Promptly improving cochlear microcirculation may benefit patients with borderline elevated TC.
{"title":"Traditional and non-traditional lipid parameters as risk factors for sudden sensorineural hearing loss","authors":"Xiaoyan Chen , Zhong Zheng , Ximeng Liu , Jianuo Huang , Daoyu Xie , Yanmei Feng","doi":"10.1016/j.bjorl.2024.101435","DOIUrl":"10.1016/j.bjorl.2024.101435","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose was to explore the effects of traditional and non-traditional lipid parameters on Sudden Sensorineural Hearing Loss (SSNHL).</p></div><div><h3>Methods</h3><p>The study included 452 patients diagnosed with SSNHL, among whom 206 patients had a level of hearing improvement ≥10 dB after one month of follow-up. A propensity score-matched (2:1) control group was used. Conditional and unconditional logistic regression were used to analyze the risk factors for SSNHL.</p></div><div><h3>Results</h3><p>Patients with SSNHL had a higher risk of concomitant hypertension and elevated atherosclerogenic lipid levels, with apolipoprotein B and apolipoprotein E identified as independent risk factors for the onset of SSNHL. Additionally, the Lipid Comprehensive Index (LCI) was an independent risk factor for the degree of hearing loss. A positive linear correlation was revealed between triglyceride, non-high-density lipoprotein cholesterol, atherogenic index, Castelli risk index, atherogenic index of plasma, LCI and hearing loss. However, no linear relationship was observed between hearing gain and any lipid parameters. When Total Cholesterol (TC) was in the range of borderline high, the treatment effect was the best. However, the statistical significance disappeared upon adjusting for confounding factors.</p></div><div><h3>Conclusion</h3><p>Patients with SSNHL exhibited markedly dysregulated lipid metabolism. Elevated serum lipid levels may be a causative factor in auditory impairment and can influence the extent of hearing loss. Promptly improving cochlear microcirculation may benefit patients with borderline elevated TC.</p></div><div><h3>Level of evidence</h3><p>4.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424000508/pdfft?md5=9cb1708e8923f32a3d0324771293368c&pid=1-s2.0-S1808869424000508-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}