Pub Date : 2025-08-05DOI: 10.1016/j.bjorl.2025.101695
Wilker Antunes Lira , Gilmar Felisberto Junior , Marco Aurélio Fornazieri , Wilma Terezinha Anselmo Lima , Ingrid Werner Picinini , Vanessa Ramos Pires Dinarte
Objective
To investigate the prevalence of undiagnosed olfactory changes in individuals over 40 and the associated factors.
Methods
A cross-sectional study enrolled a group of adult and elderly patients who did not report any nasal issues or olfactory changes with a clear or highly probable causal connection. They were subjected to the University of Pennsylvania Smell Identification Test (UPSIT) and the Visual Analog Scale to evaluate olfactory capacity.
Results
Two hundred eighty-four volunteers participated. Among the elderly, 96.9% experienced olfactory changes, while 80.4% of the younger group did. There was a significant correlation between age and UPSIT results (Rho = 0.33, p < 0.001) in the elderly. A higher prevalence of olfactory impairment was found in the elderly (p < 0.001). The age predictor showed an OR of 1.081 (p < 0.01, 95% CI 1.03–1.12). Both elderly and adults reported similar rates of altered olfaction, at 14.5% and 14.3%, respectively.
Conclusion
There was a higher prevalence and risk of developing decreased olfaction in the elderly, with an 8% greater risk of olfactory dysfunction for each passing year.
Level of evidence
5.
目的了解40岁以上人群嗅觉变化未确诊的患病率及相关因素。方法一项横断面研究纳入了一组成人和老年患者，他们没有报告任何鼻腔问题或嗅觉变化与明确或高度可能的因果关系。他们接受了宾夕法尼亚大学嗅觉识别测试（UPSIT）和视觉模拟量表来评估嗅觉能力。结果共有284名志愿者参与。在老年人中，96.9%的人经历了嗅觉变化，而在年轻人中，这一比例为80.4%。年龄与UPSIT结果有显著相关性(Rho = 0.33, p <；0.001)。老年人嗅觉障碍患病率较高(p <；0.001)。年龄预测因子OR为1.081 (p <；0.01, 95% ci 1.03-1.12)。老年人和成年人报告的嗅觉改变率相似，分别为14.5%和14.3%。结论老年人嗅觉功能下降的患病率和风险较高，嗅觉功能障碍的风险每年增加8%。证据水平。
{"title":"Prevalence of decreased olfactory function in adults in a Brazilian population sample","authors":"Wilker Antunes Lira , Gilmar Felisberto Junior , Marco Aurélio Fornazieri , Wilma Terezinha Anselmo Lima , Ingrid Werner Picinini , Vanessa Ramos Pires Dinarte","doi":"10.1016/j.bjorl.2025.101695","DOIUrl":"10.1016/j.bjorl.2025.101695","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the prevalence of undiagnosed olfactory changes in individuals over 40 and the associated factors.</div></div><div><h3>Methods</h3><div>A cross-sectional study enrolled a group of adult and elderly patients who did not report any nasal issues or olfactory changes with a clear or highly probable causal connection. They were subjected to the University of Pennsylvania Smell Identification Test (UPSIT) and the Visual Analog Scale to evaluate olfactory capacity.</div></div><div><h3>Results</h3><div>Two hundred eighty-four volunteers participated. Among the elderly, 96.9% experienced olfactory changes, while 80.4% of the younger group did. There was a significant correlation between age and UPSIT results (Rho = 0.33, p < 0.001) in the elderly. A higher prevalence of olfactory impairment was found in the elderly (p < 0.001). The age predictor showed an OR of 1.081 (p < 0.01, 95% CI 1.03–1.12). Both elderly and adults reported similar rates of altered olfaction, at 14.5% and 14.3%, respectively.</div></div><div><h3>Conclusion</h3><div>There was a higher prevalence and risk of developing decreased olfaction in the elderly, with an 8% greater risk of olfactory dysfunction for each passing year.</div></div><div><h3>Level of evidence</h3><div>5.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101695"},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-29DOI: 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.
{"title":"Impact of prosthesis position on hearing outcomes in otosclerosis patients based on ultra-high-resolution CT","authors":"Chen Yang , Heyu Ding , Ting Zhang , Pengfei Zhao , Zhenchang Wang , Shusheng Gong , Jing Xie","doi":"10.1016/j.bjorl.2025.101688","DOIUrl":"10.1016/j.bjorl.2025.101688","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to explore the impact of prosthesis position on hearing outcomes in otosclerosis patients based on Ultra-High-Resolution CT (U-HRCT).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>Prosthesis position and postoperative hearing outcomes are related. Postoperative imaging evaluation is especially important for patients who did not benefit substantially from stapes surgery.</div></div><div><h3>Level of evidence</h3><div>Level 3.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101688"},"PeriodicalIF":1.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Clinicopathological analysis of hyalinizing clear cell carcinoma in the head and neck","authors":"Xiaoli Zhao, Donglin Ma, Yahui Li, Dongmei Yang, Yingshi Piao","doi":"10.1016/j.bjorl.2025.101676","DOIUrl":"10.1016/j.bjorl.2025.101676","url":null,"abstract":"<div><h3>Objective</h3><div>To study clinicopathological features and differential diagnosis of hyalinizing clear cell carcinoma in the head and neck.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Level of evidence</h3><div>Level 1.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101676"},"PeriodicalIF":1.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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。
{"title":"Sequential flaps reconstruction in head and neck cancer: A systematic review","authors":"Yu Xiong , Zepeng Xu , Mailudan Ainiwaer , Zheng Jiang , Fei Chen","doi":"10.1016/j.bjorl.2025.101693","DOIUrl":"10.1016/j.bjorl.2025.101693","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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%).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101693"},"PeriodicalIF":1.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-29DOI: 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.
{"title":"The effect of nigella sativa oil on healing in nasal septum perforations","authors":"Ahmet Koder , Onur Ersoy","doi":"10.1016/j.bjorl.2025.101678","DOIUrl":"10.1016/j.bjorl.2025.101678","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Level of evidence</h3><div>Level 3.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101678"},"PeriodicalIF":1.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-29DOI: 10.1016/j.bjorl.2025.101689
Miguel Caballero-Borrego , Juan J. Grau , Neus Basté , Paola C. Castillo , Cristina Teixido , Izaskun Valduvieco , Isabel Vilaseca
Objectives
To analyze the presence of cancer stem cells markers in consecutive patients with locally advanced Head and Neck Squamous Cell Carcinoma (HNSCC) and establish their suitability as a prognostic biomarker in samples from routine practice.
Methods
Retrospective study of 104 consecutive patients with locally advanced HNSCC treated with definitive surgery and adjuvant chemoradiotherapy. Immunohistochemical expression of CD44, HLA-I, pan-cytokeratin, and phosphorylated Epidermal Growth Factor Receptor (p-EGFR) were evaluated in surgical specimens. Overall Survival (OS) and Disease-Free Survival (DFS) rates were calculated based on clinical characteristics and the total positive score (for tumor marker expression). Hazard ratios were calculated by Cox multivariate analysis.
Results
After a median follow-up of 50-months, higher OS rates were observed for patients without cervical node pathological involvement (p < 0.001), patients with HLA-I overexpression and a total positive score ≥ 15% (p = 0.017), and patients with low CD44 expression and a total positive score ≤ 60% (p = 0.022). Grouping by p-EGFR (p = 0.648) or pan-cytokeratin (p = 0.477) expression did not show statistical differences in OS. None of the biomarkers were associated with different DFS rates. Cox multivariate analysis revealed that positive cervical nodes (HR = 1.294; 95% CI 1.025–1.634; p = 0.030) and the expressions of HLA (HR = 0.373; 95% CI 0.168‒0.829; p = 0.015) and CD44 (HR = 2.170; 95% CI 1.031–4.569; p = 0.041) were independently associated with OS.
Conclusion
Nodal involvement, HLA-I overexpression, and decreased CD44 expression are independent prognostic factors of survival in patients with locally advanced HNSCC.
{"title":"Cancer stem cell biomarkers in locally advanced head and neck squamous cell carcinoma","authors":"Miguel Caballero-Borrego , Juan J. Grau , Neus Basté , Paola C. Castillo , Cristina Teixido , Izaskun Valduvieco , Isabel Vilaseca","doi":"10.1016/j.bjorl.2025.101689","DOIUrl":"10.1016/j.bjorl.2025.101689","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the presence of cancer stem cells markers in consecutive patients with locally advanced Head and Neck Squamous Cell Carcinoma (HNSCC) and establish their suitability as a prognostic biomarker in samples from routine practice.</div></div><div><h3>Methods</h3><div>Retrospective study of 104 consecutive patients with locally advanced HNSCC treated with definitive surgery and adjuvant chemoradiotherapy. Immunohistochemical expression of CD44, HLA-I, pan-cytokeratin, and phosphorylated Epidermal Growth Factor Receptor (p-EGFR) were evaluated in surgical specimens. Overall Survival (OS) and Disease-Free Survival (DFS) rates were calculated based on clinical characteristics and the total positive score (for tumor marker expression). Hazard ratios were calculated by Cox multivariate analysis.</div></div><div><h3>Results</h3><div>After a median follow-up of 50-months, higher OS rates were observed for patients without cervical node pathological involvement (p < 0.001), patients with HLA-I overexpression and a total positive score ≥ 15% (p = 0.017), and patients with low CD44 expression and a total positive score ≤ 60% (p = 0.022). Grouping by p-EGFR (p = 0.648) or pan-cytokeratin (p = 0.477) expression did not show statistical differences in OS. None of the biomarkers were associated with different DFS rates. Cox multivariate analysis revealed that positive cervical nodes (HR = 1.294; 95% CI 1.025–1.634; p = 0.030) and the expressions of HLA (HR = 0.373; 95% CI 0.168‒0.829; p = 0.015) and CD44 (HR = 2.170; 95% CI 1.031–4.569; p = 0.041) were independently associated with OS.</div></div><div><h3>Conclusion</h3><div>Nodal involvement, HLA-I overexpression, and decreased CD44 expression are independent prognostic factors of survival in patients with locally advanced HNSCC.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101689"},"PeriodicalIF":1.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the clinical efficacy of high-frequency electrocautery under electronic laryngoscopy combined with acid-suppressing drugs (Proton Pump Inhibitor, PPI) in the treatment of Refractory Laryngeal Contact Granuloma (RLCG).
Methods
A total of 42 patients with RLCG, treated at our hospital from January 2019 to January 2024 were included in this study. The patients underwent high-frequency electrocautery to excise laryngeal granulomas under local anesthesia using electronic laryngoscopy, followed by PPI therapy. Follow-up started one-month post-surgery and lasted for 6–12 months (average of 8.5 months), to assess the cure rate and overall efficacy.
Results
The cure rate was 76.19%, and the overall efficacy rate was 92.86%. On average, each patient underwent 1.79 procedures. The combined treatment of high-frequency electrocautery under local anesthesia with electronic laryngoscopy and PPI therapy demonstrated significant therapeutic effects for RLCG. The treatment was simple, well-tolerated by patients, cost-effective, and resulted in rapid symptom improvement, all without the need for general anesthesia or intubation.
Conclusion
The combined approach of high-frequency electrocautery under local anesthesia with electronic laryngoscopy and PPI therapy is effective in treating refractory laryngeal contact granuloma. This method offers the advantages of a straightforward surgical procedures, high patient tolerance, low cost, quick symptom relief, and no requirement for general anesthesia or intubation.
Level of evidence
Level 4-Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence.
{"title":"Clinical outcomes of high-frequency electrocautery surgery and proton pump inhibitor therapy for refractory laryngeal contact granuloma","authors":"Zelong Wang, Xianbin Lan, Yuan Fang, Shaoping Peng, Riqun Jin, Dongming Deng, Zhiheng Song","doi":"10.1016/j.bjorl.2025.101690","DOIUrl":"10.1016/j.bjorl.2025.101690","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical efficacy of high-frequency electrocautery under electronic laryngoscopy combined with acid-suppressing drugs (Proton Pump Inhibitor, PPI) in the treatment of Refractory Laryngeal Contact Granuloma (RLCG).</div></div><div><h3>Methods</h3><div>A total of 42 patients with RLCG, treated at our hospital from January 2019 to January 2024 were included in this study. The patients underwent high-frequency electrocautery to excise laryngeal granulomas under local anesthesia using electronic laryngoscopy, followed by PPI therapy. Follow-up started one-month post-surgery and lasted for 6–12 months (average of 8.5 months), to assess the cure rate and overall efficacy.</div></div><div><h3>Results</h3><div>The cure rate was 76.19%, and the overall efficacy rate was 92.86%. On average, each patient underwent 1.79 procedures. The combined treatment of high-frequency electrocautery under local anesthesia with electronic laryngoscopy and PPI therapy demonstrated significant therapeutic effects for RLCG. The treatment was simple, well-tolerated by patients, cost-effective, and resulted in rapid symptom improvement, all without the need for general anesthesia or intubation.</div></div><div><h3>Conclusion</h3><div>The combined approach of high-frequency electrocautery under local anesthesia with electronic laryngoscopy and PPI therapy is effective in treating refractory laryngeal contact granuloma. This method offers the advantages of a straightforward surgical procedures, high patient tolerance, low cost, quick symptom relief, and no requirement for general anesthesia or intubation.</div></div><div><h3>Level of evidence</h3><div>Level 4-Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101690"},"PeriodicalIF":1.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-29DOI: 10.1016/j.bjorl.2025.101675
Miguel Soares Tepedino , Luziana de Lima Ramalho , Leonardo Balsalobre , Andrea Santos Dumont Costa Curta , Debora de Carvalho Garcez , Rogerio Pezato
Objective
To describe a novel endoscopic approach to the Uncinate Process (UP) via the agger nasi region and evaluate its anatomical basis and clinical outcomes.
Methods
This study comprised two components. In the imaging study, 51 paranasal sinus CT scans were analyzed to measure the distance between the UP and the medial orbital wall at the agger nasi and ethmoid infundibulum regions, using standardized coronal and axial planes. In the clinical study, 53 patients with chronic rhinosinusitis underwent uncinectomy through the agger nasi approach. Pre- and postoperative SNOT-22 scores were compared after 6-months of follow-up, and complications were recorded.
Results
The distance from the UP to the orbit was significantly greater at the agger nasi region compared to the ethmoid infundibulum on both sides (p < 0.001). Clinically, the agger nasi approach allowed consistent identification of the maxillary sinus ostium and preservation of key anatomical structures. There was a significant improvement in SNOT-22 scores postoperatively (p < 0.001), with no major complications observed.
Conclusion
The agger nasi approach to the UP is a safe, reproducible, and effective technique. The greater distance from the UP to the orbit in this region may reduce the risk of orbital injury and facilitate complete identification of the natural drainage pathway of the maxillary sinus.
{"title":"The agger nasi approach to the uncinate process: From top to bottom","authors":"Miguel Soares Tepedino , Luziana de Lima Ramalho , Leonardo Balsalobre , Andrea Santos Dumont Costa Curta , Debora de Carvalho Garcez , Rogerio Pezato","doi":"10.1016/j.bjorl.2025.101675","DOIUrl":"10.1016/j.bjorl.2025.101675","url":null,"abstract":"<div><h3>Objective</h3><div>To describe a novel endoscopic approach to the Uncinate Process (UP) via the agger nasi region and evaluate its anatomical basis and clinical outcomes.</div></div><div><h3>Methods</h3><div>This study comprised two components. In the imaging study, 51 paranasal sinus CT scans were analyzed to measure the distance between the UP and the medial orbital wall at the agger nasi and ethmoid infundibulum regions, using standardized coronal and axial planes. In the clinical study, 53 patients with chronic rhinosinusitis underwent uncinectomy through the agger nasi approach. Pre- and postoperative SNOT-22 scores were compared after 6-months of follow-up, and complications were recorded.</div></div><div><h3>Results</h3><div>The distance from the UP to the orbit was significantly greater at the agger nasi region compared to the ethmoid infundibulum on both sides (p < 0.001). Clinically, the agger nasi approach allowed consistent identification of the maxillary sinus ostium and preservation of key anatomical structures. There was a significant improvement in SNOT-22 scores postoperatively (p < 0.001), with no major complications observed.</div></div><div><h3>Conclusion</h3><div>The agger nasi approach to the UP is a safe, reproducible, and effective technique. The greater distance from the UP to the orbit in this region may reduce the risk of orbital injury and facilitate complete identification of the natural drainage pathway of the maxillary sinus.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101675"},"PeriodicalIF":1.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objectives of this work were to evaluate the results of otosclerosis surgery and to study the predictors of its functional success.
Methods
Our study was retrospective on 322 patients, equivalent to 418 ears operated in the otolaryngology and head and neck surgery department, from January 2000 to December 2020.
Results
Hearing success was noted in 89.5% of patients considering the Postoperative Residual Air Bone Gap (PRABG) ≤10 dB criterion; in 94.3% of patients according to the conductive gain ≥20 dB criterion; in 96.4% of patients based on the improvement of cochlear reserve criterion; in 88.8% according to the Air Bone Gap improvement (ABGi) ≥70% criterion and in 81.8% considering all these criteria. The short, medium and long-term postoperative tonal audiometries could be superimposed, reflecting the stability of the hearing results. A regression of tinnitus has been reported in 79.2% of cases. The independent predictors of hearing success were the Aubry's audiometric stages I and II, mean preoperative air curve >40 dB and platinotomy. The independent predictors of tinnitus regression retained were male sex, no exposure to loud noise and Veillon radiological stages I and II.
Conclusion
The identification of factors influencing the functional results of surgery allows a better selection of candidates for the intervention and more relevant information for patients.
Level of evidence
Level 3: Non-randomized controlled cohort or follow-up study.
{"title":"Functional outcomes of otosclerosis surgery","authors":"Nadia Romdhane, Dorra Chiboub, Amal Nessib, Ameni Amri, Ines Hariga, Chiraz Chaouch Mbarek","doi":"10.1016/j.bjorl.2025.101679","DOIUrl":"10.1016/j.bjorl.2025.101679","url":null,"abstract":"<div><h3>Objectives</h3><div>The objectives of this work were to evaluate the results of otosclerosis surgery and to study the predictors of its functional success.</div></div><div><h3>Methods</h3><div>Our study was retrospective on 322 patients, equivalent to 418 ears operated in the otolaryngology and head and neck surgery department, from January 2000 to December 2020.</div></div><div><h3>Results</h3><div>Hearing success was noted in 89.5% of patients considering the Postoperative Residual Air Bone Gap (PRABG) ≤10 dB criterion; in 94.3% of patients according to the conductive gain ≥20 dB criterion; in 96.4% of patients based on the improvement of cochlear reserve criterion; in 88.8% according to the Air Bone Gap improvement (ABGi) ≥70% criterion and in 81.8% considering all these criteria. The short, medium and long-term postoperative tonal audiometries could be superimposed, reflecting the stability of the hearing results. A regression of tinnitus has been reported in 79.2% of cases. The independent predictors of hearing success were the Aubry's audiometric stages I and II, mean preoperative air curve >40 dB and platinotomy. The independent predictors of tinnitus regression retained were male sex, no exposure to loud noise and Veillon radiological stages I and II.</div></div><div><h3>Conclusion</h3><div>The identification of factors influencing the functional results of surgery allows a better selection of candidates for the intervention and more relevant information for patients.</div></div><div><h3>Level of evidence</h3><div>Level 3: Non-randomized controlled cohort or follow-up study.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101679"},"PeriodicalIF":1.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144597563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Expression of ApoE and Spp1 in the cochlea and auditory cortex of age-related hearing loss mice","authors":"Yingxue Yuan , Junhong Zhang , Jingyi Zhao , Xiru Zhang , Zhixin Cao","doi":"10.1016/j.bjorl.2025.101674","DOIUrl":"10.1016/j.bjorl.2025.101674","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Level of evidence</h3><div>Level 2.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 6","pages":"Article 101674"},"PeriodicalIF":1.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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