Brazilian Journal of Otorhinolaryngology最新文献_第7页

Clinical predictors of survival in malignant peripheral nerve sheath tumors of the head and neck: A cox regression and nomogram study 头颈部恶性周围神经鞘肿瘤生存的临床预测因素：cox回归和nomogram研究

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2025-11-01 Epub Date: 2025-08-22 DOI: 10.1016/j.bjorl.2025.101702

Sun LiNa , Tu Jianfei , Tian Zhifeng , Wang Xinbin , Wu Hui

Objectives

Malignant Peripheral Nerve Sheath Tumors (MPNST) are rapidly progressing Schwann cell neoplasms. This study aimed to develop a practical clinical nomogram that predicts prognosis in patients with Head and Neck MPNST (HN-MPNST) using the Surveillance, Epidemiology, and End Results (SEER) database.

Methods

We extracted clinical data from patients with HN MPNST between 2000 and 2020 from the SEER database. Patients were randomly divided into training cohort and validation cohorts. To estimate the chance of survival in patients with HN MPNST, we developed a nomogram. The nomogram performance was evaluated by discrimination and calibration. In addition, a decision curve analysis was conducted to evaluate the clinical usefulness of this newly developed model. Molecular data highlighting the most frequent mutations in MPNST were obtained from the Catalogue Of Somatic Mutations In Cancer (COSMIC) database.

Results

In the primary cohort, 431 patients met the inclusion criteria to be entered into this study. The median Overall Survival (OS) was 3.9-years (95% CI 2.8–6.7), and the 1-, 3-, and 5-year OS rates were 75.2%, 52.6%, and 47.1%, respectively. We included 129 consecutive patients in the validation cohort. AJCC (American Joint Committee on Cancer) staging, Collaborative Stage (CS) extension, and CS tumor size were included in the nomogram. The calibration plots showed an agreement between the predictions and observations. Based on the clinical decision curve, the model had a net clinical benefit for patients with MPNST. Analysis of COSMIC data revealed frequent mutations of MPNST in NF1 (22%), SMARCB1 (21%), TP53 (12%), SUZ12 (19%), and less commonly in BRAF and CDKN2A (each 2%).

Conclusion

Radiotherapy improves survival in patients with metastatic disease or tumors ≥ 6 cm. Using this nomogram can assist in clinical decision making, as it has satisfactory accuracy. However, an additional external validation is required.

Level of evidence

2.

目的恶性周围神经鞘肿瘤（MPNST）是一种进展迅速的雪旺细胞肿瘤。本研究旨在利用监测、流行病学和最终结果（SEER）数据库开发一种实用的临床nomogram预测头颈部MPNST （HN-MPNST）患者的预后。方法从SEER数据库中提取2000 - 2020年HN型MPNST患者的临床资料。患者随机分为训练组和验证组。为了估计HN MPNST患者的生存机会，我们开发了一个nomogram。通过判别和校准来评价nomogram性能。此外，我们还进行了决策曲线分析，以评估该新开发模型的临床实用性。强调MPNST中最常见突变的分子数据来自于癌症体细胞突变目录（COSMIC）数据库。结果在第一队列中，有431例患者符合纳入标准。中位总生存期（OS）为3.9年（95% CI 2.8-6.7）， 1年、3年和5年OS率分别为75.2%、52.6%和47.1%。我们在验证队列中纳入了129例连续患者。美国癌症联合委员会（AJCC）分期、协同分期（CS）扩展和CS肿瘤大小均纳入nomogram。校正图显示了预测和观测之间的一致性。根据临床决策曲线，该模型对MPNST患者具有净临床效益。COSMIC数据分析显示，MPNST在NF1（22%）、SMARCB1（21%）、TP53（12%）、SUZ12（19%）中频繁突变，而在BRAF和CDKN2A中较少见（各2%）。结论放疗可提高转移性疾病或肿瘤≥6cm患者的生存率。使用该图可以帮助临床决策，因为它具有令人满意的准确性。但是，需要额外的外部验证。证据水平2。

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引用次数: 0

Impact of prosthesis position on hearing outcomes in otosclerosis patients based on ultra-high-resolution CT 基于超高分辨率CT的假体位置对耳硬化患者听力结果的影响

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2025-11-01 Epub Date: 2025-07-29 DOI: 10.1016/j.bjorl.2025.101688

Chen Yang , Heyu Ding , Ting Zhang , Pengfei Zhao , Zhenchang Wang , Shusheng Gong , Jing Xie

Objectives

This study aimed to explore the impact of prosthesis position on hearing outcomes in otosclerosis patients based on Ultra-High-Resolution CT (U-HRCT).

Methods

We retrospectively reviewed medical records of 142 patients (182 ears) who underwent stapedotomy. We compared preoperative with postoperative hearing results. An experienced radiologist extracted data about stapes prostheses from U-HRCT images, including absolute insertion depth, relative insertion depth, angle between the prosthesis and incus, angle between the prosthesis and footplate, and the relative position of the hook clamped onto the long process of incus. We analyzed potential relationships between the imaging data and postoperative hearing outcomes.

Results

We obtained satisfactory hearing results from 129 ears postoperatively. 119 ears (92.2%) presented Air-Bone Gaps (ABG) in the 0–20 dB range. We observed statistically significant differences between mean pre- and post-operative ABG at different frequencies (0.5, 1, 2, and 4 kHz). The best results occurred at 2 kHz (98.5%). We found that the observed values for prosthesis insertion depth (mean 0.6 mm, relative depth: mean 23%) and mean angle between the prosthesis and incus (mean 91.2 °) were safe and effective. We also found that the mean angle between prosthesis and footplate was related to postoperative ABG (p = 0.049). The hook position on the long process of incus (relative distance of 10.5%) is also a crucial factor in determining postoperative hearing results (p = 0.726).

Conclusion

Prosthesis position and postoperative hearing outcomes are related. Postoperative imaging evaluation is especially important for patients who did not benefit substantially from stapes surgery.

Level of evidence

Level 3.

目的基于超高分辨率CT (uhrct)，探讨假体体位对耳硬化症患者听力结果的影响。方法回顾性分析142例（182耳）镫骨切开术患者的临床资料。我们比较了术前和术后的听力结果。经验丰富的放射科医师从U-HRCT图像中提取镫骨假体的数据，包括绝对插入深度、相对插入深度、假体与砧骨之间的角度、假体与脚板之间的角度以及钩夹在砧骨长程上的相对位置。我们分析了成像数据与术后听力结果之间的潜在关系。结果129耳术后获得满意的听力效果。119耳（92.2%）在0 ~ 20 dB范围内出现气骨间隙（ABG）。我们观察到术前和术后不同频率（0.5、1、2和4 kHz）的平均ABG差异有统计学意义。在2 kHz时效果最好（98.5%）。我们发现假体插入深度（平均0.6 mm，相对深度：平均23%）和假体与砧木之间的平均角度（平均91.2°）的观察值是安全有效的。我们还发现假体与足板之间的平均角度与术后ABG有关（p = 0.049）。钩在牙长程上的位置（相对距离10.5%）也是决定术后听力结果的关键因素（p = 0.726）。结论假体位置与术后听力预后相关。术后影像学评估对于没有从镫骨手术中获益的患者尤为重要。证据等级：3级。

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引用次数: 0

Competencies in Head and Neck Surgery teaching for medical internship. Position statement of Brazilian Head and Neck Surgery Society 头颈外科医学实习教学能力。巴西头颈外科学会立场声明

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2025-11-01 Epub Date: 2025-09-06 DOI: 10.1016/j.bjorl.2025.101715

Mario Augusto Ferrari de Castro , Rogerio Aparecido Dedivitis , Fatima Cristina Mendes de Matos , Marianne Yumi Nakai , Leandro Luongo de Matos , Marco Aurelio Vamondes Kulcsar , Flavio Carneiro Hojaij , Carlos Takahiro Chone , Ana Paula Souza , Giovana Meira Muller

Objectives

To standardize the necessary competencies for medical students related to Head and Neck Surgery.

Methods

The study was performed in 2025. The Delphi process was employed in its sequential phases: the selection of an expert panel; a structured questionnaire containing a preliminary list of potential competencies; the electronic distribution of the questionnaire to the experts, with options to “maintain”, “remove”, or “modify” the competencies and to suggest the inclusion of new competencies; a second round indicating “agree” or “disagree” for each reformulated or new competency; and the final consensus.

Results

Twelve competencies were established for medical students in the specialty of Head and Neck Surgery.

Conclusion

Undergraduate students should be directed toward the most prevalent conditions in the general practitioner's clinical practice.

Level of evidence

4.

目的规范头颈外科专业医学生的必备能力。方法研究时间为2025年。德尔菲法在其顺序阶段被采用：选择一个专家小组；一份包含潜在能力初步清单的结构化问卷；以电子方式向专家分发调查问卷，选择“保留”、“删除”或“修改”能力，并建议列入新的能力；第二轮对每一个重新表述的或新的能力表示“同意”或“不同意”；最后的共识。结果建立了头颈外科专业医学生的12项胜任能力。结论本科学生在全科医生的临床实践中应面向最常见的疾病。证据水平4。

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引用次数: 0

Clinicopathological analysis of hyalinizing clear cell carcinoma in the head and neck 头颈部透明细胞癌的临床病理分析

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2025-11-01 Epub Date: 2025-07-29 DOI: 10.1016/j.bjorl.2025.101676

Xiaoli Zhao, Donglin Ma, Yahui Li, Dongmei Yang, Yingshi Piao

Objective

To study clinicopathological features and differential diagnosis of hyalinizing clear cell carcinoma in the head and neck.

Methods

A retrospective analysis was performed patients with hyalinizing clear cell carcinoma in the head and neck, who underwent surgical resection in Beijing Tongren Hospital affiliated to Capital Medical University from January 2014 to May 2024. The clinical features of HCCC were analyzed by computed tomography and magnetic resonance imaging. Tumor sections were further characterized using hematoxylin and eosin staining, immunohistochemistry, and fluorescence in situ hybridization.

Results

There were 4 male and 5 female cases in 9 patients. The age range was 28–84 years-old, the middle age was 60 years-old. 9 patients, 5 in the nasopharynx, 2 in the base of the tongue, and 2 in the oropharynx. At the cellular level, the HCCC tumors were composed of transparent and eosinophilic cells (in various ratios), which were typically arranged into nests, cords, and trabeculae, and embedded in a glassy hyaline substance. Immunohistochemical evaluation showed positivity for CK7, P63, P40, CK5/6, and negativity for S100, SMA, GFAP, and calponin. Fluorescence in situ hybridization revealed EWSR1 rearrangement in all the nine patients evaluated.

Conclusions

Hyalinizing clear cell carcinoma is a rare low-grade salivary gland carcinoma that mostly occurs in the minor salivary glands. They had an indolent disease course, with few metastases. Our study shows that the above combination of analytical techniques can be used to accurately characterize and diagnose HCCC.

Level of evidence

Level 1.

目的探讨头颈部透明细胞癌的临床病理特点及鉴别诊断。方法回顾性分析2014年1月至2024年5月在首都医科大学附属北京同仁医院行手术切除的头颈部透明细胞癌患者。通过计算机断层扫描和磁共振成像分析HCCC的临床特征。肿瘤切片采用苏木精和伊红染色、免疫组织化学和荧光原位杂交进一步表征。结果9例患者中男4例，女5例。年龄范围为28-84岁，中年为60岁。9例，鼻咽部5例，舌底2例，口咽部2例。在细胞水平上，HCCC肿瘤由不同比例的透明和嗜酸性细胞组成，典型排列成巢状、索状和小梁状，包埋在玻璃状透明物质中。免疫组化评价显示CK7、P63、P40、CK5/6呈阳性，S100、SMA、GFAP和钙钙蛋白呈阴性。荧光原位杂交显示所有9例患者的EWSR1重排。结论涎化透明细胞癌是一种罕见的低级别唾液腺癌，多发生在小唾液腺。他们的病程缓慢，很少有转移。我们的研究表明，上述分析技术的组合可以用来准确地表征和诊断HCCC。证据等级：1级。

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引用次数: 0

Sequential flaps reconstruction in head and neck cancer: A systematic review 序贯皮瓣重建头颈癌：系统回顾

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2025-11-01 Epub Date: 2025-07-29 DOI: 10.1016/j.bjorl.2025.101693

Yu Xiong , Zepeng Xu , Mailudan Ainiwaer , Zheng Jiang , Fei Chen

Objectives

For patients with Head and Neck Cancer (HNC), flap reconstruction is one of the treatment modalities for large head and neck defects. While most patients achieve satisfactory outcomes with a single flap, some may require a second or additional flaps due to various reasons. The aim of our study was to systematically review the relevant articles and investigate the application of sequential flaps in reconstruction of patients with HNC.

Methods

Two authors independently screened articles from PubMed, EBSCO, and Web of Science. Studies were included if they reported at least one of the following outcomes: duration of operation or hospitalization, flap-related postoperative complications, flap success rate, and follow-up outcomes.

Results

A total of 17 articles were included, comprising 832 patients and 1037 flaps (excluding the number of flaps used in initial reconstructions). The overall flap failure rate was 5.4%. Among the 314 flap-related postoperative complications, the most common were revision (5.8%), complete flap necrosis (5.2%), and arterial or venous thrombosis (3.3%).

Conclusion

Sequential flaps are an optional and effective reconstructive modality for HNC patients. However, prospective studies are needed to explore prognostic-related risk factors and better determine the suitability of sequential flaps for individual patients. Additionally, since reconstruction impacts both aesthetics and function, it is crucial to emphasize during preoperative discussions that postoperative outcomes may not fully align with patient expectations.

目的头颈部肿瘤（HNC）患者皮瓣重建是头颈部大面积缺损的治疗方式之一。虽然大多数患者通过单个皮瓣获得满意的结果，但由于各种原因，有些患者可能需要第二次或额外的皮瓣。本研究的目的是系统地回顾相关文献，探讨顺序皮瓣在HNC患者重建中的应用。方法两名作者独立筛选PubMed、EBSCO和Web of Science的文章。如果研究报告了以下至少一项结果：手术或住院时间、皮瓣相关术后并发症、皮瓣成功率和随访结果，则纳入研究。结果共纳入17篇文献，包括832例患者和1037个皮瓣（不包括首次重建使用的皮瓣数量）。皮瓣整体失败率为5.4%。在314例皮瓣相关术后并发症中，最常见的是翻修（5.8%）、皮瓣完全坏死（5.2%）和动脉或静脉血栓形成（3.3%）。结论序贯皮瓣是HNC患者可选择的、有效的修复方式。然而，需要前瞻性研究来探索与预后相关的危险因素，并更好地确定顺序皮瓣对个体患者的适用性。此外，由于重建会影响美观和功能，在术前讨论时强调术后结果可能不完全符合患者的期望是至关重要的。

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引用次数: 0

Expression of ApoE and Spp1 in the cochlea and auditory cortex of age-related hearing loss mice ApoE和Spp1在老年性听力损失小鼠耳蜗和听觉皮层的表达

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2025-11-01 Epub Date: 2025-07-09 DOI: 10.1016/j.bjorl.2025.101674

Yingxue Yuan , Junhong Zhang , Jingyi Zhao , Xiru Zhang , Zhixin Cao

Objective

Screen for differential proteins in the cochlea of mice associated with Age-Related Hearing Loss (ARHL), analyze and validate the expression of specific differential proteins and genes in the cochlea and auditory cortex of ARHL mice, and preliminarily explore their potential mechanisms of action.

Methods

ABR (Auditory Brainstem Response) hearing tests were conducted to select 15-month-old C57BL/6 mice with significantly decreased hearing as the experimental group and 2-month-old mice with normal hearing as the control group. Cochleae were dissected, and unlabeled quantitative proteomics was employed to identify and analyze differentially expressed proteins in the inner ear of the two groups of mice. Key node proteins were selected via the STRING database and Cytoscape analysis. The expression of two selected proteins, ApoE and Spp1, in the cochlea was detected using qRT-PCR, Western blot, and immunofluorescence techniques, and their expression in the auditory cortex of the brain was further explored.

Results

Label-free quantitative proteomics identified 115 differentially expressed proteins in the cochlea of 15-month-old ARHL mice compared to 2-month-old hearing-normal mice, including 42 upregulated and 73 downregulated proteins. GO and KEGG enrichment analyses revealed significant enrichment of differentially expressed proteins in functions and signaling pathways associated with neurodegenerative diseases and neurotransmission. Protein-Protein Interaction (PPI) analysis using the STRING database and Cytoscape selection identified ApoE and Spp1 as key hub proteins. Validation via qRT-PCR, Western blot, and immunofluorescence demonstrated that both ApoE and Spp1 were highly expressed in the cochlea and auditory cortex of the ARHL mice compare to 2-month-old hearing-normal mice.

Conclusion

ApoE and Spp1 are upregulated in the cochlea of ARHL mice, particularly in spiral ganglion neurons, and in the auditory cortex, suggesting their potential involvement in the pathogenesis and progression of ARHL through the modulation of auditory neural conduction systems.

Level of evidence

Level 2.

目的筛选与年龄相关性听力损失（Age-Related Hearing Loss， ARHL）相关小鼠耳蜗中的差异蛋白，分析并验证ARHL小鼠耳蜗和听觉皮层中特异性差异蛋白和基因的表达，并初步探讨其可能的作用机制。方法选择15月龄听力明显下降的C57BL/6小鼠作为实验组，2月龄听力正常的小鼠作为对照组，进行听觉脑干反应（sabr）听力测试。解剖耳蜗，采用未标记定量蛋白质组学方法对两组小鼠内耳差异表达蛋白进行鉴定分析。通过STRING数据库和Cytoscape分析选择关键节点蛋白。采用qRT-PCR、Western blot和免疫荧光技术检测ApoE和Spp1两种蛋白在耳蜗中的表达，并进一步探讨其在大脑听觉皮层中的表达。结果15月龄ARHL小鼠耳蜗与2月龄听力正常小鼠相比，鉴定出115种差异表达蛋白，包括42种上调蛋白和73种下调蛋白。GO和KEGG富集分析显示，与神经退行性疾病和神经传递相关的功能和信号通路中差异表达蛋白显著富集。利用STRING数据库和Cytoscape筛选进行蛋白-蛋白相互作用（PPI）分析，确定ApoE和Spp1为关键枢纽蛋白。通过qRT-PCR、Western blot和免疫荧光验证，与2月龄听力正常的小鼠相比，ApoE和Spp1在ARHL小鼠的耳蜗和听觉皮层中均有高表达。结论apoe和Spp1在ARHL小鼠耳蜗，尤其是螺旋神经节神经元和听觉皮层中表达上调，提示它们可能通过调节听觉神经传导系统参与ARHL的发病和进展。证据等级：2级。

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引用次数: 0

Assessment of depression in total laryngectomy patients 全喉切除术患者抑郁的评估

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2025-11-01 Epub Date: 2025-08-05 DOI: 10.1016/j.bjorl.2025.101677

Kelen Fernanda Catarochi, Vaneli Colombo Rossi, Carlos Takahiro Chone

Objective

Of this study was to evaluate the presence and severity of depressive symptoms in total laryngectomy patients and identify variations in results of each item on the depression scale.

Methods

This study is a quantitative, analytical and cross-sectional study, with 30 total laryngectomized participants, using the Instrument (BDI-II) Beck Depression Inventory-II, from April to July 2024, all total laryngectomized participants who attended the Head and Neck surgery Otorhinolaryngology Outpatient Clinic and were invited to participate in the research, the assessment was carried out by the same reserarcher and the estimated response time was 22 min.

Results

Show tha depression was identified in 20% of patients with mild symptoms, 13% moderate and 20% severe. The sleep pattern was altered in 63% of respondents and difficulty concentrating was reported by 57%. Altered appetit was identified in 53%. The feeling of sadness was identified in 60% of patients, also crying, pessimism and loss of interest in 40%. Regarding irritability, agitation and feelings of punishment, 47% of participants showed changes. The self-criticism and self-esteem were preserved in 70% and 63% respectively. Suicidal thoughts or desires were identified in 17% and any percentage for this resuts needs attention. The group was 80% male, the average age of participants is 65±7-years. Married patientes are 67%, divorced 20%, singles 3% and widower are 10%. The time after surgery ranged fron 1 to 10 years; 50% had undergone chemotherapy and 73% denied post-surgical complications.

Conclusion

This this study points to is that 53% of patients showed signs of depression on some scale.

Level of evidence

Level 3.

目的评估全喉切除术患者抑郁症状的存在和严重程度，并确定抑郁量表各项目结果的差异。方法本研究采用定量、分析和横断面研究方法，于2024年4月至7月在头颈外科耳鼻咽喉科门诊就诊的30名全喉切除术患者，采用BDI-II贝克抑郁量表- ii进行全喉切除术。评估由同一研究人员进行，估计反应时间为22分钟。结果显示，20%的轻度症状患者被确诊为抑郁症，13%为中度症状，20%为重度症状。63%的受访者的睡眠模式发生了改变，57%的人报告说注意力难以集中。53%的患者出现食欲改变。60%的患者有悲伤的感觉，40%的患者也有哭泣、悲观和失去兴趣的感觉。在易怒、躁动和惩罚感方面，47%的参与者表现出了变化。自我批评和自尊分别保留了70%和63%。有17%的人有自杀的想法或欲望，任何比例的结果都需要注意。本组男性占80%，平均年龄65±7岁。已婚患者占67%，离婚患者占20%，单身患者占3%，鳏夫占10%。术后时间1 ~ 10年；50%的患者接受了化疗，73%的患者否认术后并发症。结论这项研究指出的是53%的患者在某种程度上表现出抑郁的迹象。证据等级：3级。

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引用次数: 0

Effects of fibroblasts-derived exosomal FAP in regulating EMT in epithelial cells from chronic rhinosinusitis 成纤维细胞来源的外泌体FAP在调节慢性鼻窦炎上皮细胞EMT中的作用

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2025-11-01 Epub Date: 2025-09-06 DOI: 10.1016/j.bjorl.2025.101703

Li-Fang Shen, Zi-Ming Fu, Hai-Hong Chen

Objectives

Exosomes play a crucial role in intercellular communication and may contribute to the development of various diseases. Nevertheless, their role in Nasal Polyps (NPs) remains poorly understood. Herein, Nasal Polyp Fibroblasts (NPF) were used to release exosomes, and epithelial cells were cocultured with NPF-derived exosomes to analyze Epithelial-Mesenchymal Transition (EMT) in Chronic Rhinosinusitis (CRS).

Methods

We obtained exosomes from the culture media of NPFs treated with or without Fibroblast Activation Protein (FAP) inhibitor-4. Epithelial cells were coincubated with NPF-derived exosomes, and exosome internalization was analyzed by confocal microscopy. FAP and EMT markers in epithelial cells were detected by Western blotting and RT-PCR, while the migration ability of epithelial cells was detected by scratch experiments.

Results

NPF-derived FAP-containing exosomes were rapidly internalized by nasal epithelial cells. These exosomes induced epithelial cells to express reduced E-cadherin and increased N-cadherin and vimentin levels, while FAPI-4 could reverse these changes. Furthermore, the migration ability of epithelial cells was enhanced by FAP-carrying exosomes. Our results reveal that FAP-containing exosomes promote EMT in epithelial cells.

Conclusion

NPF-derived FAP-containing exosomes mediate the interaction between epithelial cells and fibroblasts and induce the EMT of epithelial cells, thereby potentially playing a crucial role in promoting remodeling in CRS. These findings suggest that FAP is a potential therapeutic target for the treatment of CRS patients.

Level of evidence

Level 3 ‒ Non-randomized controlled cohort/follow-up study Recommendation B.

目的外泌体在细胞间通讯中起重要作用，并可能参与多种疾病的发生。然而，它们在鼻息肉（NPs）中的作用仍然知之甚少。本研究利用鼻息肉成纤维细胞（NPF）释放外泌体，并将上皮细胞与NPF衍生的外泌体共培养，分析慢性鼻窦炎（CRS）的上皮-间充质转化（EMT）。方法用纤维母细胞活化蛋白（FAP）抑制剂-4或不加FAP抑制剂-4处理的NPFs培养基中获得外泌体。上皮细胞与npf来源的外泌体共孵育，并通过共聚焦显微镜分析外泌体的内化。采用Western blotting和RT-PCR检测上皮细胞中的FAP和EMT标志物，采用划痕实验检测上皮细胞的迁移能力。结果snpf衍生的含fap的外泌体被鼻上皮细胞迅速内化。这些外泌体诱导上皮细胞表达E-cadherin减少，N-cadherin和vimentin水平升高，而FAPI-4可以逆转这些变化。此外，携带fap的外泌体增强了上皮细胞的迁移能力。我们的研究结果表明，含有fap的外泌体促进上皮细胞的EMT。结论npf衍生的含有fap的外泌体介导上皮细胞和成纤维细胞的相互作用，诱导上皮细胞的EMT，从而可能在促进CRS重构中发挥重要作用。这些发现提示FAP是治疗CRS患者的潜在治疗靶点。证据水平：3级——非随机对照队列/随访研究。

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引用次数: 0

The effect of nigella sativa oil on healing in nasal septum perforations 黑草油对鼻中隔穿孔愈合的影响

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2025-11-01 Epub Date: 2025-07-29 DOI: 10.1016/j.bjorl.2025.101678

Ahmet Koder , Onur Ersoy

Objective

Nasal Septal Perforation (NSP) is a challenging condition with limited treatment options, often resulting in symptoms like nasal obstruction and epistaxis. Nigella Sativa Oil (NSO), known for its anti-inflammatory and regenerative properties, has shown promise in promoting wound healing. This study aims to investigate the effects of NSO on the wound healing process in an experimental NSP model using rats, exploring its potential as a therapeutic agent for NSP treatment.

Methods

Twenty-two male Sprague Dawley rats were randomly assigned to two groups. Each subject had a Nasal Septal Perforation (NSP) approximately 2 mm in diameter created. NSO (study group) and saline (control group) were applied topically once a day for 14 days. At the end of the 14th day, the rats were sacrificed, and their nasal septa were excised for macroscopic and histopathological examination. Immunohistochemically Vascular Endothelial Growth Factor (VEGF) and Proliferating Nuclear Cell Antigen (PCNA) parameters examined. Tissue morphology was evaluated, collagen density was measured. The macroscopic closure rate of the NSPs and the histopathological parameters were analyzed statistically.

Results

NSO group showed significantly higher collagen density, surface morphology score, International Cartilage Repair Society (ICRS) matrix examination score, PCNA immunoreactivity and macroscopic closure rate of NSPs compared to the saline group (p < 0.05). In terms of VEGF immunoreactivity, no difference was detected between both groups (p > 0.05).

Conclusion

Locally administered NSO may enhance wound healing in the nasal septum within an experimental NSP model, suggesting that NSO could be an effective alternative or adjunctive treatment for NSP, promoting better clinical outcomes.

Level of evidence

Level 3.

鼻中隔穿孔（NSP）是一种具有挑战性的疾病，治疗方案有限，通常导致鼻塞和鼻出血等症状。黑草油（NSO）以其抗炎和再生特性而闻名，在促进伤口愈合方面表现出了希望。本研究旨在研究NSO对实验性NSP大鼠伤口愈合过程的影响，探讨其作为治疗NSP的药物的潜力。方法雄性sd大鼠22只，随机分为两组。每个受试者都有一个直径约2毫米的鼻中隔穿孔（NSP）。NSO（研究组）和生理盐水（对照组）局部应用，每天1次，连用14 d。第14天处死大鼠，切除鼻中隔进行肉眼和组织病理学检查。免疫组织化学检测血管内皮生长因子（VEGF）和增殖核细胞抗原（PCNA）参数。观察组织形态，测定胶原蛋白密度。统计分析nsp的宏观闭合率和组织病理学参数。结果与生理盐水组相比，snso组胶原密度、表面形态学评分、国际软骨修复学会（ICRS）基质检查评分、PCNA免疫反应性和nsp宏观闭合率均显著升高（p < 0.05）。VEGF免疫反应性两组比较差异无统计学意义（p > 0.05）。结论在实验性鼻中隔鼻炎模型中，局部应用NSO可促进鼻中隔伤口愈合，提示NSO可作为鼻中隔鼻炎的有效替代或辅助治疗方法，促进更好的临床疗效。证据等级：3级。

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引用次数: 0

The Green Cochlea 绿色的耳蜗

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Brazilian Journal of Otorhinolaryngology

Pub Date : 2025-11-01 Epub Date: 2025-09-06 DOI: 10.1016/j.bjorl.2025.101718

Abdulrahman Hagr , Farid Alzhrani , Fida Almuhawas , Yassin Abdelsamad , Medhat Yousef , Asma Alahmadi , Christiana Kyvelidou , Ilona Anderson

Objectives

Healthcare systems contribute significantly to global greenhouse gas emissions through energy consumption and waste generation. This study aims to explore strategies to make cochlear implantation processes more environmentally sustainable and aligned with the United Nations’ Sustainable Development Goals.

Methods

We examined various approaches including the use of bio-based and biodegradable materials, sustainable energy solutions, greener anesthetic practices, effective waste separation and recycling in operating rooms, and patient-centered strategies such as reducing travel and promoting early activation and fitting of cochlear implants.

Results

Establishing a ‘Green Team’ was identified as a key factor to raise awareness and motivation for sustainability initiatives. Implementing these strategies can significantly reduce the environmental footprint of cochlear implantation by decreasing surgical waste, lowering energy consumption, and minimizing patient-related emissions.

Conclusion

By adopting these sustainable practices, the cochlear implant field can reduce its environmental impact, contribute meaningfully to global sustainability efforts, and enhance patient well-being, positioning itself as a leader in healthcare sustainability.

医疗保健系统通过能源消耗和废物产生对全球温室气体排放做出了重大贡献。本研究旨在探索使人工耳蜗植入过程更具环境可持续性并符合联合国可持续发展目标的策略。方法我们研究了各种方法，包括使用生物基和可生物降解材料，可持续能源解决方案，更环保的麻醉实践，有效的手术室废物分类和回收，以及以患者为中心的策略，如减少旅行和促进早期激活和安装人工耳蜗。结果建立“环保团队”是提高可持续发展意识和动力的关键因素。实施这些策略可以显著减少人工耳蜗植入的环境足迹，减少手术浪费，降低能源消耗，并最大限度地减少与患者相关的排放。结论通过采用这些可持续实践，人工耳蜗领域可以减少其对环境的影响，为全球可持续发展做出有意义的贡献，并提高患者的福祉，使其成为医疗保健可持续发展的领导者。

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引用次数: 0