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In Reference to Clinical Effects and Response Time of Biological Drugs in Chronic Rhinosinusitis with Nasal Polyps Patients: Real-Life Experience. 参考生物药物治疗慢性鼻窦炎合并鼻息肉患者的临床疗效和反应时间:现实经验。
IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-10 DOI: 10.1002/lary.32002
Pietro Orlando, Oreste Gallo
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引用次数: 0
Increasing Incidence of Facial Nerve Disorders in the United States from 2007 to 2022. 从2007年到2022年,美国面神经疾病的发病率不断增加。
IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-10 DOI: 10.1002/lary.31997
Eric X Wei, Allen Green, Jon-Paul Pepper, Sarah R Akkina

Background: Incidence data on Facial Nerve Disorders (FND) and Bell's palsy are currently limited. Prior epidemiological studies have estimated the incidence rate of Bell's palsy to be between 11 and 53/100,000 individuals, although the most cited incidence data are from single regions or municipalities, many of which are outdated from several decades ago.

Methods: This was a retrospective cohort study of US adults from 2007 to 2022 using the Merative™ Marketscan® Research Databases. Trends in the incidence of FND were described overall and by specific sociodemographic groups, including age, sex, region, and insurance plan type. Chi-squared and simple logistic regression analyses were performed.

Results: From 2007 to 2022, the total adult incidence of all FND was 30.5/100,000, and the total incidence of Bell's palsy alone was 24.5/100,000. Over the study period, there was a significant annual increase of 2.1 cases of FND/100,000 adults (95% Confidence Interval [CI] 1.8, 2.3; p < 0.001), and a significant total increase of 1.5 cases of Bell's palsy/100,000 adults (95% CI 1.2, 1.7; p < 0.001). The total incidence of FND was higher in males (33.1/100,000) than in females (28.4/100,000, p < 0.001), and greater in older age groups (p < 0.001). Additionally, the incidence of FND varied significantly by region (p < 0.001) and insurance plan type (p < 0.001).

Conclusions: This study provides up-to-date incidence rates for Bell's palsy and facial nerve disorders, based on national administrative claims data. Incidence rates of FND and Bell's palsy alone have been increasing in the United States from 2007 to 2022.

Level of evidence: III Laryngoscope, 2025.

背景:目前面神经疾病(FND)和贝尔氏麻痹的发病率数据有限。先前的流行病学研究估计,贝尔氏麻痹的发病率在每10万人中有11到53人之间,尽管被引用最多的发病率数据来自单个地区或直辖市,其中许多数据是几十年前的过时数据。方法:使用Merative™Marketscan®研究数据库,对2007年至2022年的美国成年人进行回顾性队列研究。FND发病率的趋势被总体描述,并按特定的社会人口群体,包括年龄、性别、地区和保险计划类型。进行卡方和简单逻辑回归分析。结果:2007 - 2022年,所有FND的成人总发病率为30.5/10万,仅贝尔麻痹的总发病率为24.5/10万。在研究期间,每10万成年人中FND病例每年显著增加2.1例(95%置信区间[CI] 1.8, 2.3;结论:基于国家行政索赔数据,本研究提供了贝尔氏麻痹和面神经疾病的最新发病率。在美国,从2007年到2022年,FND和贝尔氏麻痹的发病率一直在上升。证据级别:III喉镜,2025年。
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引用次数: 0
Evaluation of Tumor-Infiltrating Leukocytes in Endolymphatic Sac Tumor. 内淋巴囊肿瘤浸润性白细胞的评价。
IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-10 DOI: 10.1002/lary.32000
Pei Zhou, Xunbei Shi, Mengye Ma, Qianru Wu, Feitian Li, Chunfu Dai

Objective: Endolymphatic sac tumors (ELSTs), as rare low-grade neoplasms, are primarily treated with surgery. This study analyzes the characteristics of tumor-infiltrating leukocytes (TILs) in ELSTs and their relationships with clinical features to explore the potential for immunotherapy in ELSTs.

Methods: Clinical data and tumor specimens of 10 ELSTs patients who underwent surgery were retrieved. Immune expression levels of CD3, CD4, CD8, and CD66b were assessed by immunohistochemical staining and expressed as the integral optical density (IOD). Hematoxylin and eosin (HE) staining were performed to define the tumor nest and stroma of ELSTs.

Results: There were no significant differences in the IOD of CD3, CD4, CD8, and CD66b between the tumor nest and stroma or between von Hippel-Lindau (VHL) and non-VHL patients. The IOD of CD3, CD4, CD8, and CD66b appeared relatively higher in patients with endolymphatic hydrops (EH) than those without. Additionally, CD4 expression in the tumor stroma was significantly higher in patients with EH (p = 0.0381).

Conclusion: TILs were present in both ELSTs nest and stroma with significant individual heterogeneity observed among patients. Patients with VHL disease showed a similar immune pattern to those with sporadic ELSTs. Notably, the ELST-related EH may be associated with lymphocytes infiltration. Combined with surgical intervention, immunotherapy may serve as an effective adjuvant therapeutic strategy.

Level of evidence: 4 Laryngoscope, 2025.

目的:内淋巴囊肿瘤(ELSTs)是一种罕见的低级别肿瘤,主要采用手术治疗。本研究分析ELSTs中肿瘤浸润性白细胞(tumor-浸润性白细胞,til)的特征及其与临床特征的关系,探讨ELSTs免疫治疗的潜力。方法:回顾性分析10例ELSTs手术患者的临床资料及肿瘤标本。免疫组织化学染色评估CD3、CD4、CD8和CD66b的免疫表达水平,并以积分光密度(IOD)表示。苏木精和伊红(HE)染色确定ELSTs的肿瘤巢和间质。结果:瘤巢与间质、VHL与非VHL患者CD3、CD4、CD8、CD66b的IOD差异无统计学意义。内淋巴水肿(EH)患者CD3、CD4、CD8、CD66b的IOD明显高于无EH患者。此外,EH患者肿瘤基质中CD4表达显著升高(p = 0.0381)。结论:内皮细胞内皮细胞巢和基质中均存在til,且患者间存在显著的个体异质性。VHL患者与散发性ELSTs患者表现出相似的免疫模式。值得注意的是,elst相关的EH可能与淋巴细胞浸润有关。结合手术干预,免疫治疗可作为有效的辅助治疗策略。证据等级:4喉镜,2025。
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引用次数: 0
Outcomes of Endoscopic versus Microscopic Ossicular Chain Reconstruction-A Systematic Review and Meta-analysis. 内镜下与显微镜下听骨链重建的结果:系统回顾和meta分析。
IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-09 DOI: 10.1002/lary.31991
Chee Y Lim, Brian S Y Yeo, Xue Y Goh, Raymond Y S Ngo, Woei S Loh, Eunice D Kwa

Objective: The efficacy of the transcanal endoscopic approach in tympanoplasty, cholesteatoma removal, and stapedotomy is detailed. This study reviews evidence on the feasibility of endoscopic ossiculoplasty as a suitable alternative to traditional microscopic ossiculoplasty.

Data sources: PubMed, Embase, and Cochrane Library were searched from inception to 19 June 2024 for articles comparing endoscopic and microscopic ossicular chain reconstruction.

Review methods: This systematic review was conducted in accordance with PRISMA guidelines. The primary outcomes assessed include air bone gap closure, pre-operative and post-operative air bone gap, pure tone audiometry, and word recognition scores. The secondary outcomes include operation time, surgical success, and surgical complications. These outcomes between microscopic and endoscopic techniques were pooled and compared as mean differences using a random-effects model. The Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) and Cochrane Risk-of-Bias Tool for Randomized Trials (RoB2) scale were adopted to assess for study bias in observational studies and randomized controlled trials, respectively.

Results: This study included five studies comprising 504 patients. While endoscopic ossiculoplasty had shorter operating durations (95% CI -42.97 to -1.57), it conferred comparable air bone gap closure (95% CI -0.34 to 3.76), post-operative pure tone audiogram (95% CI 10.97-18.77), and surgical success. Additional qualitative strengths identified in endoscopic ear surgery include improvements in visualization, decreased need for supplemental incisions, excellent ergonomics, and reduced post-operative pain.

Conclusion: Overall, endoscopic ossiculoplasty may confer comparable audiological outcomes to microscopic ossiculoplasty and may serve as a reasonable alternative surgical approach. Laryngoscope, 2025.

目的:详细介绍经鼻内镜入路在鼓室成形术、胆脂瘤切除及镫骨切除术中的应用效果。本研究回顾了内窥镜听骨成形术作为传统显微听骨成形术的合适替代方法的可行性证据。数据来源:PubMed, Embase和Cochrane图书馆从成立到2024年6月19日检索比较内窥镜和显微镜下听骨链重建的文章。评价方法:本系统评价按照PRISMA指南进行。评估的主要结果包括气骨间隙闭合、术前和术后气骨间隙、纯音听力学和单词识别评分。次要结果包括手术时间、手术成功率和手术并发症。使用随机效应模型将显微镜和内窥镜技术之间的这些结果汇总并作为平均差异进行比较。采用非随机干预研究的偏倚风险(ROBINS-I)和Cochrane随机试验的偏倚风险工具(RoB2)量表分别评估观察性研究和随机对照试验的研究偏倚。结果:本研究包括5项研究,共504例患者。虽然内窥镜下听骨成形术的手术时间较短(95% CI -42.97至-1.57),但它具有相当的空气骨隙关闭(95% CI -0.34至3.76),术后纯音听音(95% CI 10.97-18.77)和手术成功率。内窥镜耳部手术的其他定性优势包括视觉效果的改善,减少了补充切口的需要,良好的人体工程学,减少了术后疼痛。结论:总的来说,内窥镜下听骨成形术与显微下听骨成形术的听力学效果相当,可以作为一种合理的替代手术方法。喉镜,2025年。
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引用次数: 0
Long-Term Auditory and Speech Outcomes of Cochlear Implantation in Children with IP-I Malformation. i型耳蜗畸形儿童人工耳蜗植入术的远期听觉和言语效果。
IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-08 DOI: 10.1002/lary.31988
Xianqi Liu, Xiuhua Chao, Ruijie Wang, Jianfen Luo, Min Wang, JinMing Li, Fangxia Hu, Lei Xu

Objectives: This study aimed to investigate the long-term auditory and speech outcomes in children with Incomplete Partition Type I (IP-I) who underwent cochlear implantation (CI) and compared their progress to implanted children with normal cochlea.

Methods: This study tracked 17 children with IP-Ι for an average of 3.5 years post-implantation. A control group with normal cochlea was also tracked. Regular assessments, including aided hearing threshold, categories of auditory performance (CAP), and speech intelligibility rating (SIR), were conducted every 6 months for the first 2 years post-CI and annually thereafter. Speech recognition was tested for children who could cooperate with it.

Results: The aided hearing threshold of IP-I children had improved significantly from 90.51 dB HL before CI to 47.02 dB HL in the sixth-month post-CI, and it had further improved to 26.27 dB HL after more than 48 months post-CI. Meanwhile, their median CAP scores had improved from 0 to 6.5 and median SIR scores from 1 to 4 over the same period. There was no significant difference in the improvement of mean aided hearing thresholds over time between the IP-I and control groups postoperation. However, IP-I children showed slower progress in CAP and SIR scores and had lower recognition rates for monosyllabic and disyllabic words compared with the control group.

Conclusion: Children with IP-Ι showed continuous but slower improvement in auditory and speech capabilities post-CI compared to those with normal cochlea. Their speech recognition ability was also inferior.

Level of evidence: III Laryngoscope, 2025.

目的:本研究旨在探讨I型不完全隔型(IP-I)儿童接受人工耳蜗植入术(CI)后的长期听觉和言语预后,并将其进展与正常耳蜗植入术儿童进行比较。方法:本研究追踪17例IP患儿-Ι,平均为植入后3.5年。耳蜗正常的对照组也被跟踪。在ci后的前两年每6个月进行一次定期评估,包括辅助听力阈值、听觉表现类别(CAP)和语音清晰度评级(SIR)。对能够配合语音识别的儿童进行了测试。结果:ipi患儿的辅助听力阈值从CI前的90.51 dB HL显著提高到CI后6个月的47.02 dB HL, CI后48个月进一步提高到26.27 dB HL。同时,在同一时期,他们的CAP中位数得分从0提高到6.5,SIR中位数得分从1提高到4。术后IP-I组和对照组的平均辅助听力阈值随时间的改善无显著差异。然而,与对照组相比,IP-I儿童在CAP和SIR分数上的进步较慢,对单音节和双音节单词的识别率较低。结论:与耳蜗正常的儿童相比,IP-Ι儿童的听觉和言语能力在ci后表现出持续但缓慢的改善。他们的语音识别能力也较差。证据级别:III喉镜,2025年。
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引用次数: 0
Pediatric Bilateral Vestibular Hypofunction: A Review of 26 Cases. 小儿双侧前庭功能减退26例分析。
IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-08 DOI: 10.1002/lary.31996
Tiffany Peng Hwa, Colin Villarin, Kathleen Davin, Erin Field, Melissa Caine, Robert O'Reilly

Objective: Peripheral bilateral vestibular hypofunction (BVH) is a rare condition that is well-studied in the adult population, whereas characterization in children has been limited. We report a pediatric cohort of patients with BVH at a multidisciplinary, tertiary care pediatric vestibular clinic.

Methods: A record review of 832 patients with balance-related complaints in our center was conducted. Multidisciplinary evaluations in Otolaryngology, Physical Therapy (PT), and Audiology were reviewed for each subject, and data were entered into a REDCap database for further analysis.

Results: Twenty-six individuals met diagnostic criteria for BVH. The cohort consisted of 17 females and nine males, with a mean age of 5.24 years (1.41-17.35; SD 3.97). Thirteen subjects had diagnoses of one or more concurrent neurodevelopmental syndromes. Sensorineural hearing loss (SNHL) was present in 21 (80.8%) subjects, of which 17 were profound in severity and 14 had undergone cochlear implant surgery. Seventeen (65.4%) children were able to complete vHIT testing, revealing reduced lateral semicircular canal (SCC) gains bilaterally in 11 cases. Twenty-one (80.8%) patients received recommendation for PT services, of which 15 were for vestibular therapy specifically. Patients who completed their course of vestibular PT achieved improved functional goal outcomes and discharge from therapy in nine of 11 (81.8%) cases.

Conclusion: We present a case series of pediatric patients with bilateral vestibular hypofunction. BVH in this population is often associated with SNHL and comorbid congenital or neurodevelopmental diagnoses. Vestibular physical therapy may provide a significant improvement in quality of life for patients.

Level of evidence: Level 4 Laryngoscope, 2025.

目的:外周双侧前庭功能减退(BVH)是一种罕见的疾病,在成人人群中得到了很好的研究,而儿童的特征却有限。我们报告了一个多学科三级儿科前庭门诊BVH患者的儿科队列。方法:对我院832例与平衡相关的主诉患者进行回顾性分析。对每个受试者的耳鼻喉科、物理治疗(PT)和听力学的多学科评估进行回顾,并将数据输入REDCap数据库进行进一步分析。结果:26例患者符合BVH诊断标准。该队列包括17名女性和9名男性,平均年龄5.24岁(1.41-17.35;SD 3.97)。13名受试者被诊断为一种或多种并发神经发育综合征。感音神经性听力损失21例(80.8%),其中重度17例,人工耳蜗术后14例。17例(65.4%)儿童能够完成vHIT测试,其中11例显示双侧侧半规管(SCC)增益减小。21例(80.8%)患者接受了PT服务推荐,其中15例专门用于前庭治疗。完成前庭PT疗程的患者11例中有9例(81.8%)实现了功能目标的改善和治疗出院。结论:我们报告了一系列小儿双侧前庭功能障碍的病例。该人群中的BVH通常与SNHL和先天性或神经发育性诊断共病有关。前庭物理治疗可显著改善患者的生活质量。证据级别:4级喉镜,2025。
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引用次数: 0
Association of Social Vulnerability Index With Declining Recommended Surgical Treatment in Head and Neck Cancer Patients. 头颈癌患者社会脆弱性指数与手术治疗推荐率下降的关系
IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-08 DOI: 10.1002/lary.31999
Soroush Ershadifar, Jonathan T Mo, Angela A Colback, Arnaud F Bewley, Marianne Abouyared, Andrew C Birkeland

Objective: To investigate the impact of county-level social vulnerability on patients' decision to refuse recommended surgical treatment.

Methods: Retrospective cohort analysis conducted on HNSCC cases documented in the latest available SEER databases from 2000 to 2020; various demographic, including county of residence, and disease-related variables were collected. CDC's Social Vulnerability Index (SVI) was assigned based on patients' county of residence, and patients were subsequently categorized into four SVI quartiles. Pearson chi-square tests and binomial logistic regression was conducted to determine the impact of variables on patients' refusal of surgical treatment.

Results: Among 83,184 patients, 2.6% (2,165) refused surgical intervention recommended by their physician as part of treatment. Social vulnerability (higher SVI), male sex, older age, more advanced disease stage, belonging to non-Hispanic Black or Native Hawaiian/Asian Pacific Islander Race and Origin, and single marital status were associated with higher likelihood of refusing surgery.

Conclusion: SVI is a significant factor in the refusal of recommended surgical treatment in HNSCC patients. Advanced disease stages and social vulnerability appear to interplay, influencing treatment decisions. Culturally competent care and support for socially vulnerable patients may mitigate disparities in treatment acceptance, potentially improving survival outcomes.

Level of evidence: 3 Laryngoscope, 2025.

目的:探讨县级社会脆弱性对患者拒绝推荐手术治疗决策的影响。方法:对2000 - 2020年最新SEER数据库中记录的HNSCC病例进行回顾性队列分析;收集了各种人口统计数据,包括居住地和疾病相关变量。CDC的社会脆弱性指数(SVI)是根据患者居住的县分配的,随后将患者分为四个SVI四分位数。采用Pearson卡方检验和二项logistic回归确定各变量对患者拒绝手术治疗的影响。结果:在83,184例患者中,2.6%(2,165例)的患者拒绝接受医生推荐的手术治疗。社会脆弱性(SVI较高)、男性、年龄较大、疾病晚期、非西班牙裔黑人或夏威夷原住民/亚太岛民的种族和血统以及单身婚姻状况与拒绝手术的可能性较高相关。结论:SVI是HNSCC患者拒绝推荐手术治疗的重要因素。疾病晚期和社会脆弱性似乎相互作用,影响治疗决策。文化上合格的护理和支持社会弱势患者可以减轻治疗接受的差异,潜在地改善生存结果。证据等级:3喉镜,2025。
{"title":"Association of Social Vulnerability Index With Declining Recommended Surgical Treatment in Head and Neck Cancer Patients.","authors":"Soroush Ershadifar, Jonathan T Mo, Angela A Colback, Arnaud F Bewley, Marianne Abouyared, Andrew C Birkeland","doi":"10.1002/lary.31999","DOIUrl":"https://doi.org/10.1002/lary.31999","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of county-level social vulnerability on patients' decision to refuse recommended surgical treatment.</p><p><strong>Methods: </strong>Retrospective cohort analysis conducted on HNSCC cases documented in the latest available SEER databases from 2000 to 2020; various demographic, including county of residence, and disease-related variables were collected. CDC's Social Vulnerability Index (SVI) was assigned based on patients' county of residence, and patients were subsequently categorized into four SVI quartiles. Pearson chi-square tests and binomial logistic regression was conducted to determine the impact of variables on patients' refusal of surgical treatment.</p><p><strong>Results: </strong>Among 83,184 patients, 2.6% (2,165) refused surgical intervention recommended by their physician as part of treatment. Social vulnerability (higher SVI), male sex, older age, more advanced disease stage, belonging to non-Hispanic Black or Native Hawaiian/Asian Pacific Islander Race and Origin, and single marital status were associated with higher likelihood of refusing surgery.</p><p><strong>Conclusion: </strong>SVI is a significant factor in the refusal of recommended surgical treatment in HNSCC patients. Advanced disease stages and social vulnerability appear to interplay, influencing treatment decisions. Culturally competent care and support for socially vulnerable patients may mitigate disparities in treatment acceptance, potentially improving survival outcomes.</p><p><strong>Level of evidence: </strong>3 Laryngoscope, 2025.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Critical View of Safety: Anatomical Key to Avoid Injury to Recurrent Laryngeal Nerve in Transoral Endoscopic Thyroidectomy
IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-07 DOI: 10.1002/lary.32001
Sanjay Kumar Yadav MS, MCh, Pawan Agarwal MS, MCh, Dhananjaya Sharma MS, PhD, DSc, FRCS

In this study, we propose a critical view of safety to promote standard visual identification and preservation of RLN during TOETVA.

Laryngoscope, 135:1227–1228, 2025

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引用次数: 0
The Association of Sarcopenia and Body Composition With Benign Positional Paroxysmal Vertigo in Older Adults. 老年人良性体位性阵发性眩晕与骨骼肌减少症和体成分的关系。
IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-06 DOI: 10.1002/lary.31995
Sultan Keskin Demircan, Fatih Öner

Objectives: One-third of older adults suffer from dizziness and vertigo. Benign positional paroxysmal vertigo (BPPV), which occurs due to otoconia moving into the semicircular canal, is the most common vestibular disorder. We evaluated the connection between BPPV and geriatric symptoms.

Methods: A comprehensive geriatric evaluation included daily living activities, Mini-Mental State Examination (MMSE), and Geriatric Depression Scale tests for all patients. Patients' nutritional status was assessed using the Mini-Nutritional Assessment. Body weight and fat free mass were determined from the bioimpedance analyzer. Hand grip strength was measured using an electronic hand dynamometer to determine muscle strength. Sarcopenia was assessed using the European Working Group on Sarcopenia in Older People-2 recommendations. The patients were divided into three groups as BPPV-positive, BPPV-negative, and healthy (control).

Results: Obesity, low muscle mass, dynapenia, gait speed, low gait speed, and history of falling statistically significantly differed between the three groups, but age, gender, smoking, alcohol consumption, body mass index, MMSE, depression, number of falls, and comorbid diseases did not differ. The BPPV-positive group had greater rates of obesity, low muscle mass, dynapenia, and sarcopenia than the control group (p = 0.008, 0.007, 0.01, 0.03). In the unadjusted univariate analysis, low muscle mass, sarcopenia, and obesity were risk factors for "BPPV" (Odds Ratio [OR]: 3.43, Confidence Interval [Cl]: 1.25-9.37, p = 0.016; OR: 3.47, Cl: 1.32-9.13, p = 0.011; OR: 2.71, Cl: 1.09-6.70, p = 0.031).

Conclusions: Obesity, sarcopenia, and low muscle mass are risk factors for BPPV, and we urge the older population to adopt healthy diet and exercise regimens to reduce BPPV-related falls.

Level of evidence: Level 3 Laryngoscope, 2025.

目标:三分之一的老年人患有头晕和眩晕。良性位置性阵发性眩晕(BPPV)是最常见的前庭疾病,其发生原因是耳石进入半规管。我们对 BPPV 与老年症状之间的联系进行了评估:对所有患者进行全面的老年病学评估,包括日常生活活动、小型精神状态检查(MMSE)和老年抑郁量表测试。患者的营养状况通过 "迷你营养评估 "进行评估。体重和游离脂肪量由生物阻抗分析仪测定。使用电子手部测力计测量手部握力,以确定肌肉力量。评估 "肌肉疏松症 "时采用了欧洲老年人肌肉疏松症工作组-2 的建议。患者被分为三组:BPPV 阳性组、BPPV 阴性组和健康组(对照组):三组患者在肥胖、低肌肉量、动态肌无力、步态速度、低步态速度和跌倒史方面存在显著统计学差异,但在年龄、性别、吸烟、饮酒、体重指数、MMSE、抑郁、跌倒次数和合并疾病方面没有差异。与对照组相比,BPPV 阳性组的肥胖、低肌肉质量、动态肌无力症和肌少症发生率更高(P = 0.008、0.007、0.01、0.03)。在未经调整的单变量分析中,低肌肉量、肌肉疏松症和肥胖是 "BPPV "的风险因素(Odds Ratio [OR]:3.43,置信区间 [Cl]:1.25-9.37,P = 0.016;OR:3.47, Cl: 1.32-9.13, p = 0.011; OR: 2.71, Cl: 1.09-6.70, p = 0.031):结论:肥胖、肌肉疏松症和低肌肉量是导致BPPV的危险因素,我们呼吁老年人采用健康的饮食和运动方式,以减少与BPPV相关的跌倒:证据级别:3 级 《喉镜》,2025 年。
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引用次数: 0
Laryngeal Cancer in the West of Scotland 2014-2020: Trends and Survival in a Cohort of 867 Patients. 2014-2020年苏格兰西部喉癌:867例患者队列的趋势和生存率
IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2025-01-06 DOI: 10.1002/lary.31992
Rhona Hurley, Claire Paterson, David I Conway, Gareth J Inman, Catriona M Douglas

Background: Laryngeal squamous cell cancer (LSCC) accounts for around one-third of head and neck cancers, with smoking and alcohol as major risk factors. Despite advances in organ preservation, survival rates have stagnated globally over recent decades. The impact of socioeconomic deprivation on LSCC outcomes in the West of Scotland remains underexplored. We hypothesized that survival outcomes in the West of Scotland are poorer than cohorts from other developed nations.

Aim: To evaluate characteristics and survival outcomes for LSCC patients in the West of Scotland and identify predictors of survival.

Methods: A retrospective cohort study of 867 LSCC patients in the West of Scotland (2014-2020) analyzed demographics, tumor staging, performance status, treatments, and socioeconomic status (Scottish Index of Multiple Deprivation, SIMD). Subgroup differences were assessed using chi-squared tests. Survival analysis was performed with Kaplan-Meier curves, log-rank tests, and Cox proportional hazards modeling.

Results: The cohort had a male-to-female ratio of 3.2:1, with a mean age of 65.5 years, with 56% presenting with advanced disease. Most patients (70.7%) lived in the most deprived areas. Supraglottic cancers were the most common subsite (51%). Five-year overall survival (OS) was 46%, with a median OS of 52 months. Glottic cancers had better outcomes (64% OS) compared to supraglottic cancers (36%). Predictors of survival included age, subsite, performance status, alcohol use, treatment modality, and deprivation.

Conclusion: LSCC survival in the West of Scotland is lower than in other European nations, influenced by advanced-stage presentation, deprivation, and frailty. Addressing these factors is vital to improving outcomes.

Level of evidence: III Laryngoscope, 2025.

背景:喉鳞状细胞癌(LSCC)约占头颈部癌症的三分之一,吸烟和酒精是主要的危险因素。尽管在器官保存方面取得了进步,但近几十年来,全球的存活率一直停滞不前。在苏格兰西部,社会经济剥夺对LSCC结果的影响仍未得到充分探讨。我们假设苏格兰西部的生存结果比其他发达国家的人群要差。目的:评估苏格兰西部LSCC患者的特征和生存结果,并确定生存的预测因素。方法:对苏格兰西部867例LSCC患者(2014-2020年)进行回顾性队列研究,分析人口统计学、肿瘤分期、表现状况、治疗和社会经济地位(苏格兰多重剥夺指数,SIMD)。采用卡方检验评估亚组差异。生存分析采用Kaplan-Meier曲线、log-rank检验和Cox比例风险模型。结果:该队列的男女比例为3.2:1,平均年龄为65.5岁,其中56%为晚期疾病。大多数患者(70.7%)生活在最贫困地区。声门上癌是最常见的亚位点(51%)。5年总生存率(OS)为46%,中位OS为52个月。与声门上癌(36%)相比,声门癌有更好的预后(64% OS)。预测生存的因素包括年龄、亚部位、运动状态、酒精使用、治疗方式和剥夺。结论:受晚期表现、剥夺和虚弱的影响,苏格兰西部的LSCC生存率低于其他欧洲国家。解决这些因素对于改善结果至关重要。证据级别:III喉镜,2025年。
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引用次数: 0
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Laryngoscope
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