Gulce Kirazli, Fidan Balayeva, Melis Kacan Yilmaz, Isa Kaya, Tayfun Kirazli, Figen Gokcay, Nese Celebisoy
ObjectiveImpairment in the integration of different vestibular stimuli is the proposed mechanisms in vestibular migraine (VM). In this study, it was aimed to assess the vestibulo‐ocular reflex (VOR) and dynamic visual acuity (DVA) in patients with VM and to compare the results with migraine without vestibular symptoms (MwoV), and persistent postural‐perceptual dizziness (PPPD) to find out if there are discriminative differences and search for a correlation with the levels of anxiety.MethodsTwenty‐two patients with MwoV, 23 patients with VM, 22 patients with PPPD, and 23 healthy controls (HC) were studied. Video head impulse test (vHIT) and functional head impulse test (fHIT) without and with an optokinetic background (OB) were performed. Percentage of correctly identified optotypes (CA%) was considered for the fHIT test. Beck anxiety inventory (BAI) was used to assess anxiety.ResultsLateral canal vHIT gain of the patient groups were not different from the healthy controls (p > 0.05). fHIT and fHIT/OB CA% results of all patient groups were lower than the HC (p < 0.005), and VM patients had the lowest scores for both tests. BAI scores of the PPPD patients were the highest and a correlation between anxiety levels, and fHIT results could not be identified (p > 0.05).ConclusionProminent CA% drop by the use of an OB was the main finding in patients with VM. This discriminative feature was not correlated with anxiety scores. Difficulty in resolving the conflict between visual and vestibular inputs seem to be the underlying mechanism.Level of Evidence3 Laryngoscope, 2024
目的不同前庭刺激的整合能力受损是前庭性偏头痛（VM）的拟议机制。本研究旨在评估前庭性偏头痛患者的前庭-眼反射（VOR）和动态视敏度（DVA），并将评估结果与无前庭症状的偏头痛（MwoV）和持续性姿势-知觉性头晕（PPPD）进行比较，以确定两者是否存在鉴别差异，并寻找与焦虑水平的相关性。方法研究了 22 名 MwoV 患者、23 名 VM 患者、22 名 PPPD 患者和 23 名健康对照组（HC）。分别进行了无光动力背景（OB）和有光动力背景（OB）的视频头脉冲测试（vHIT）和功能性头脉冲测试（fHIT）。fHIT 测试考虑了正确识别光型的百分比（CA%）。所有患者组的 fHIT 和 fHIT/OB CA% 结果均低于健康对照组（p <0.005），其中 VM 患者的两项测试得分最低。PPPD 患者的 BAI 分数最高，焦虑水平与 fHIT 结果之间的相关性无法确定（p > 0.05）。这一鉴别特征与焦虑评分无关。难以解决视觉和前庭输入之间的冲突似乎是潜在的机制。
{"title":"vHIT and fHIT in Patients With Migraine, Vestibular Migraine, and Persistent Postural‐Perceptual Dizziness","authors":"Gulce Kirazli, Fidan Balayeva, Melis Kacan Yilmaz, Isa Kaya, Tayfun Kirazli, Figen Gokcay, Nese Celebisoy","doi":"10.1002/lary.31758","DOIUrl":"https://doi.org/10.1002/lary.31758","url":null,"abstract":"ObjectiveImpairment in the integration of different vestibular stimuli is the proposed mechanisms in vestibular migraine (VM). In this study, it was aimed to assess the vestibulo‐ocular reflex (VOR) and dynamic visual acuity (DVA) in patients with VM and to compare the results with migraine without vestibular symptoms (MwoV), and persistent postural‐perceptual dizziness (PPPD) to find out if there are discriminative differences and search for a correlation with the levels of anxiety.MethodsTwenty‐two patients with MwoV, 23 patients with VM, 22 patients with PPPD, and 23 healthy controls (HC) were studied. Video head impulse test (vHIT) and functional head impulse test (fHIT) without and with an optokinetic background (OB) were performed. Percentage of correctly identified optotypes (CA%) was considered for the fHIT test. Beck anxiety inventory (BAI) was used to assess anxiety.ResultsLateral canal vHIT gain of the patient groups were not different from the healthy controls (<jats:italic>p</jats:italic> > 0.05). fHIT and fHIT/OB CA% results of all patient groups were lower than the HC (<jats:italic>p</jats:italic> < 0.005), and VM patients had the lowest scores for both tests. BAI scores of the PPPD patients were the highest and a correlation between anxiety levels, and fHIT results could not be identified (<jats:italic>p</jats:italic> > 0.05).ConclusionProminent CA% drop by the use of an OB was the main finding in patients with VM. This discriminative feature was not correlated with anxiety scores. Difficulty in resolving the conflict between visual and vestibular inputs seem to be the underlying mechanism.Level of Evidence3 <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Serena Pu, Spencer Johnson, Lily Martin, Benjamin Laitman, Mark Courey
ObjectiveSteroid sex hormones (SSH) target cell nuclei to affect transcription. Although laryngeal tissue is theorized to be hormonally responsive, SSH receptor presence and cellular effects on the vocal folds are not well‐established. A scoping review of this literature might inform future research.Data SourcesMedline, Embase, Scopus, and Web of Science were searched.Review MethodsThis review followed JBI and PRISMA‐ScR Guidelines. Two independent reviewers screened each title/abstract and full text according to eligibility criteria. Exclusion criteria included primary outcomes based on subjective interpretation and secondary effects on the vocal folds (e.g., voice).ResultsThree hundred and sixty one articles were screened at the title/abstract level, 83 at the full‐text level, and 32 met inclusion criteria. Fourteen studies were performed in humans and 15 in animals; 3 were review articles. In studies directly examining receptors (n = 17), estrogen receptors (ER) were found in 10 of 15 studies, progesterone receptors (PR) in 6/10, and androgen receptors (AR) in 6/9. When the effects of SSH on vocal folds were studied (n = 16), estrogen had effects in 10/13, progesterone in 3/3, and androgens in 4/5. ER and PR were mostly identified in epithelium and fibroblasts of lamina propria (LP) while AR was found in muscle, lamina propria, and epithelium.ConclusionsExisting evidence variably supports the presence of SSH receptors in vocal fold tissue; therefore, further clarification is needed. Estrogen and progesterone were most identified in mucosal tissue, where they decrease fibrosis and help maintain the epithelial barrier. Androgens appear to be pro‐fibrotic in epithelium and hypertrophic in muscle. Laryngoscope, 2024
{"title":"Cellular and Molecular Effects of Steroid Sex Hormones on the Vocal Folds: A Scoping Review","authors":"Serena Pu, Spencer Johnson, Lily Martin, Benjamin Laitman, Mark Courey","doi":"10.1002/lary.31771","DOIUrl":"https://doi.org/10.1002/lary.31771","url":null,"abstract":"ObjectiveSteroid sex hormones (SSH) target cell nuclei to affect transcription. Although laryngeal tissue is theorized to be hormonally responsive, SSH receptor presence and cellular effects on the vocal folds are not well‐established. A scoping review of this literature might inform future research.Data SourcesMedline, Embase, Scopus, and Web of Science were searched.Review MethodsThis review followed JBI and PRISMA‐ScR Guidelines. Two independent reviewers screened each title/abstract and full text according to eligibility criteria. Exclusion criteria included primary outcomes based on subjective interpretation and secondary effects on the vocal folds (e.g., voice).ResultsThree hundred and sixty one articles were screened at the title/abstract level, 83 at the full‐text level, and 32 met inclusion criteria. Fourteen studies were performed in humans and 15 in animals; 3 were review articles. In studies directly examining receptors (<jats:italic>n</jats:italic> = 17), estrogen receptors (ER) were found in 10 of 15 studies, progesterone receptors (PR) in 6/10, and androgen receptors (AR) in 6/9. When the effects of SSH on vocal folds were studied (<jats:italic>n</jats:italic> = 16), estrogen had effects in 10/13, progesterone in 3/3, and androgens in 4/5. ER and PR were mostly identified in epithelium and fibroblasts of lamina propria (LP) while AR was found in muscle, lamina propria, and epithelium.ConclusionsExisting evidence variably supports the presence of SSH receptors in vocal fold tissue; therefore, further clarification is needed. Estrogen and progesterone were most identified in mucosal tissue, where they decrease fibrosis and help maintain the epithelial barrier. Androgens appear to be pro‐fibrotic in epithelium and hypertrophic in muscle. <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ObjectiveNasal irrigation is a common treatment for sinonasal disorders; however, it is unknown if it can reduce SARS‐CoV‐2 nasopharyngeal viral load (NVL). This systematic review investigated the efficacy of nasal irrigation with saline, povidone iodine (PVP‐I), and intranasal corticosteroids (INCS) at reducing SARS‐CoV‐2 NVL and transmissibility.Data SourcesDatabases including Embase, MEDLINE, Web of Science, and ClinicalTrials.gov.Review MethodsA systematic review was completed with pre‐defined search criteria using keywords related to nasal irrigation and COVID‐19 from 1946 through January 2024. This review followed PRISMA reporting guidelines and was registered on PROSPERO. Only in‐vivo studies testing nasal irrigation with either saline, PVP‐I, or INCS for reducing NVL were included.ResultsNine out of ten studies on saline‐based solutions reported positive effects in reducing NVL, with benefits noted in earlier time to negative nasopharyngeal PCR and a greater decline in NVL during early study time points, compared with controls. Isotonic and hypertonic saline mediums were found to be effective with three studies demonstrating enhanced efficacy with additives. Four out of seven studies on PVP‐I showed a positive effect on reducing NVL, but results were heterogenous. Four studies demonstrated reduction of transmission with saline or PVP‐I. No studies were found on INCS.ConclusionSaline nasal irrigation showed the best efficacy in reducing SARS‐CoV‐2 NVL. Additives to saline may have a clinical benefit, but further studies are needed to elucidate their isolated impacts on NVL. Data on PVP‐I is inconclusive and further studies are warranted to determine the ideal concentration for irrigation. Laryngoscope, 2024
{"title":"Washing Illness Away: A Systematic Review of the Impact of Nasal Irrigation and Spray on COVID‐19","authors":"Karan Gandhi, Freeman Paczkowski, Leigh Sowerby","doi":"10.1002/lary.31761","DOIUrl":"https://doi.org/10.1002/lary.31761","url":null,"abstract":"ObjectiveNasal irrigation is a common treatment for sinonasal disorders; however, it is unknown if it can reduce SARS‐CoV‐2 nasopharyngeal viral load (NVL). This systematic review investigated the efficacy of nasal irrigation with saline, povidone iodine (PVP‐I), and intranasal corticosteroids (INCS) at reducing SARS‐CoV‐2 NVL and transmissibility.Data SourcesDatabases including Embase, MEDLINE, Web of Science, and ClinicalTrials.gov.Review MethodsA systematic review was completed with pre‐defined search criteria using keywords related to nasal irrigation and COVID‐19 from 1946 through January 2024. This review followed PRISMA reporting guidelines and was registered on PROSPERO. Only in‐vivo studies testing nasal irrigation with either saline, PVP‐I, or INCS for reducing NVL were included.ResultsNine out of ten studies on saline‐based solutions reported positive effects in reducing NVL, with benefits noted in earlier time to negative nasopharyngeal PCR and a greater decline in NVL during early study time points, compared with controls. Isotonic and hypertonic saline mediums were found to be effective with three studies demonstrating enhanced efficacy with additives. Four out of seven studies on PVP‐I showed a positive effect on reducing NVL, but results were heterogenous. Four studies demonstrated reduction of transmission with saline or PVP‐I. No studies were found on INCS.ConclusionSaline nasal irrigation showed the best efficacy in reducing SARS‐CoV‐2 NVL. Additives to saline may have a clinical benefit, but further studies are needed to elucidate their isolated impacts on NVL. Data on PVP‐I is inconclusive and further studies are warranted to determine the ideal concentration for irrigation. <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Naomi Tesema, Taylor G. Lackey, Mackenzie O'Connor, Paul E. Kwak, Aaron M. Johnson, Milan R. Amin
ObjectiveThis study aims to evaluate the clinical outcomes of patients receiving in‐office vocal fold steroid injections (VFSI), highlighting relatively new measures around vocal pitch.MethodsPatients with a diagnosis of vocal fold scar who received in‐office VFSI from 2013 to 2024 were evaluated. Pre‐ and post‐steroid Voice Handicap Index (VHI‐10) scores, stroboscopic vibratory parameters, acoustic measures of cepstral peak prominence (CPP), and fundamental frequency coefficient of variation (F0CoV) during sustained phonation were analyzed using Wilcoxon signed‐rank tests and McNemar's tests.ResultsTwenty‐two patients had follow‐up data 1–3 months after steroid injection. The median decrease in VHI‐10 after one injection was 4 points (p = 0.02). We found no difference in CPP and F0CoV measures at follow‐up. Forty‐five percent of patients improved in mucosal wave and amplitude of at least one vocal fold. Earlier presentation from vocal injury was associated with improvement in mucosal wave and amplitude of the left vocal fold (p = 0.03). We found no difference in sex, tobacco smoking history, singing status, secondary diagnosis, and baseline VHI‐10 score between patients who improved in vibratory parameters and those who did not.ConclusionThis single‐center study is one of the largest exploring patient outcomes following in‐office VFSI. Though patients reported modest improvement in voice use after VFSI, this may not be as impactful as previously believed. Improvement in videostroboscopy is expected in about half of the patients, with recency from vocal injury a likely predictor of success. These partially negative results provide insight into counseling patients regarding benefits from in‐office VFSI.Level of Evidence4 Laryngoscope, 2024
{"title":"Factors Associated With Improvement Following In‐office Steroid Injections for Vocal Fold Scar","authors":"Naomi Tesema, Taylor G. Lackey, Mackenzie O'Connor, Paul E. Kwak, Aaron M. Johnson, Milan R. Amin","doi":"10.1002/lary.31734","DOIUrl":"https://doi.org/10.1002/lary.31734","url":null,"abstract":"ObjectiveThis study aims to evaluate the clinical outcomes of patients receiving in‐office vocal fold steroid injections (VFSI), highlighting relatively new measures around vocal pitch.MethodsPatients with a diagnosis of vocal fold scar who received in‐office VFSI from 2013 to 2024 were evaluated. Pre‐ and post‐steroid Voice Handicap Index (VHI‐10) scores, stroboscopic vibratory parameters, acoustic measures of cepstral peak prominence (CPP), and fundamental frequency coefficient of variation (F0CoV) during sustained phonation were analyzed using Wilcoxon signed‐rank tests and McNemar's tests.ResultsTwenty‐two patients had follow‐up data 1–3 months after steroid injection. The median decrease in VHI‐10 after one injection was 4 points (<jats:italic>p</jats:italic> = 0.02). We found no difference in CPP and F0CoV measures at follow‐up. Forty‐five percent of patients improved in mucosal wave and amplitude of at least one vocal fold. Earlier presentation from vocal injury was associated with improvement in mucosal wave and amplitude of the left vocal fold (<jats:italic>p</jats:italic> = 0.03). We found no difference in sex, tobacco smoking history, singing status, secondary diagnosis, and baseline VHI‐10 score between patients who improved in vibratory parameters and those who did not.ConclusionThis single‐center study is one of the largest exploring patient outcomes following in‐office VFSI. Though patients reported modest improvement in voice use after VFSI, this may not be as impactful as previously believed. Improvement in videostroboscopy is expected in about half of the patients, with recency from vocal injury a likely predictor of success. These partially negative results provide insight into counseling patients regarding benefits from in‐office VFSI.Level of Evidence4 <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Artur K. Schuster, Nevra K. Yilmaz, Tomotaka Shimura, Sebahattin Cureoglu, Rafael da Costa Monsanto, Joel Lavinsky
ObjectiveTo distinguish the patterns of inner ear changes between meningogenic and otogenic routes in meningitis cases. Our hypothesis is that pinpointing distinct patterns linked to each route could aid in the development of diagnostic strategies and targeted therapies.MethodsTemporal bones (TBs) from patients with a history of meningitis and histopathological evidence of labyrinthitis were divided into two groups (otogenic and meningogenic). Inner ear histopathological examination was performed to identify qualitative and semi‐quantitative changes. This assessment encompassed inflammation patterns, indications of early ossification, hair cell loss, and alterations in the lateral wall, round window membrane, cochlear aqueduct and vestibular aqueduct.ResultsThirty‐six TBs were included in the study (otogenic, 21; meningogenic, 15). Generalized labyrinthitis was more common in otogenic cases (100% vs. 53%, p < 0.001). Early signs of cochlear ossification were exclusively observed in otogenic cases (9 TBs). The spiral ligament of otogenic cases has shown a uniform loss of fibrocytes across all cochlear turns, while meningogenic cases showed more severe loss in the apical turn. Otogenic cases exhibited a higher prevalence of severe inflammation of the cochlear aqueduct and endolymphatic sac. Meningogenic cases showed more severe loss of vestibular hair cells in the otolithic organs.ConclusionOtogenic cases displayed a higher prevalence of changes in the spiral ligament and signs of early ossification, whereas meningogenic cases were associated with a higher degree of vestibular damage. Our findings emphasize the importance of considering the infection route and its implications for timely diagnosis and development of pathology‐oriented treatment strategies.Level of EvidenceNA Laryngoscope, 2024
{"title":"Comparative Histopathologic Analysis of Inner Ear Damage in Meningitis: Otogenic Versus Meningogenic Routes","authors":"Artur K. Schuster, Nevra K. Yilmaz, Tomotaka Shimura, Sebahattin Cureoglu, Rafael da Costa Monsanto, Joel Lavinsky","doi":"10.1002/lary.31759","DOIUrl":"https://doi.org/10.1002/lary.31759","url":null,"abstract":"ObjectiveTo distinguish the patterns of inner ear changes between meningogenic and otogenic routes in meningitis cases. Our hypothesis is that pinpointing distinct patterns linked to each route could aid in the development of diagnostic strategies and targeted therapies.MethodsTemporal bones (TBs) from patients with a history of meningitis and histopathological evidence of labyrinthitis were divided into two groups (otogenic and meningogenic). Inner ear histopathological examination was performed to identify qualitative and semi‐quantitative changes. This assessment encompassed inflammation patterns, indications of early ossification, hair cell loss, and alterations in the lateral wall, round window membrane, cochlear aqueduct and vestibular aqueduct.ResultsThirty‐six TBs were included in the study (otogenic, 21; meningogenic, 15). Generalized labyrinthitis was more common in otogenic cases (100% vs. 53%, <jats:italic>p</jats:italic> < 0.001). Early signs of cochlear ossification were exclusively observed in otogenic cases (9 TBs). The spiral ligament of otogenic cases has shown a uniform loss of fibrocytes across all cochlear turns, while meningogenic cases showed more severe loss in the apical turn. Otogenic cases exhibited a higher prevalence of severe inflammation of the cochlear aqueduct and endolymphatic sac. Meningogenic cases showed more severe loss of vestibular hair cells in the otolithic organs.ConclusionOtogenic cases displayed a higher prevalence of changes in the spiral ligament and signs of early ossification, whereas meningogenic cases were associated with a higher degree of vestibular damage. Our findings emphasize the importance of considering the infection route and its implications for timely diagnosis and development of pathology‐oriented treatment strategies.Level of EvidenceNA <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tanner J. Diemer, Douglas P. Nanu, Shaun A. Nguyen, Badr Ibrahim, Ted A. Meyer, Mohamed Abdelwahab
ObjectiveTo systematically review polysomnographic and cephalometric data in obstructive sleep apnea (OSA) patients with obesity (body mass index [BMI] ≥30 kg/m2) treated with maxillomandibular advancement (MMA).Data SourcesScopus, PubMed, CINAHL, and The COCHRANE Library.Review MethodsA search was performed from inception until April 3, 2024, in each database.ResultsA total of 14 studies (143 subjects) were included. The mean age was 44.3 years (range: 17–69), 80.2% males (95% CI: 72.5–86.5), mean BMI of 35.3 (95% CI: 33.1–37.5), and mean duration to follow‐up post‐MMA was 13.7 months (95% CI: 10.1–17.3). All objective outcomes improved significantly; overall, apnea‐hypopnea index (AHI) decreased by −57.3 ([95% CI: −71.5 to −43.2], p < 0.0001) lowest oxygen saturation (LSAT) increased by 14.1% ([95% CI: 9.9 to 18.3], p < 0.0001), and Epworth Sleepiness Scale (ESS) decreased by −9.4 ([95% CI: −13.5 to −5.2], p < 0.0001). Surgical cure was 39.2% (95% CI: 20.3–60.0), and surgical success was 85.6% (95% CI: 77.8–91.5). Comparing percent reduction in class 3 obesity (−92.9%) as compared to class 1 (−85.5%) and class 2 (−83.6%) exhibited a significant difference (1 vs 3 p = 0.0012, 2 vs 3 p = 0.015).ConclusionsOur findings suggest that MMA significantly improves subjective and objective outcomes in OSA amongst patients with obesity with results comparable to the overall population. Success rates remained above 80% in studies with the highest mean BMI. In addition, patients with class 3 obesity yielded a significantly increased benefit based on percent reduction in AHI compared with class 1 and 2.Level of Evidence1 Laryngoscope, 2024
{"title":"Maxillomandibular Advancement for Obstructive Sleep Apnea in Patients With Obesity: A Meta‐Analysis","authors":"Tanner J. Diemer, Douglas P. Nanu, Shaun A. Nguyen, Badr Ibrahim, Ted A. Meyer, Mohamed Abdelwahab","doi":"10.1002/lary.31751","DOIUrl":"https://doi.org/10.1002/lary.31751","url":null,"abstract":"ObjectiveTo systematically review polysomnographic and cephalometric data in obstructive sleep apnea (OSA) patients with obesity (body mass index [BMI] ≥30 kg/m<jats:sup>2</jats:sup>) treated with maxillomandibular advancement (MMA).Data SourcesScopus, PubMed, CINAHL, and The COCHRANE Library.Review MethodsA search was performed from inception until April 3, 2024, in each database.ResultsA total of 14 studies (143 subjects) were included. The mean age was 44.3 years (range: 17–69), 80.2% males (95% CI: 72.5–86.5), mean BMI of 35.3 (95% CI: 33.1–37.5), and mean duration to follow‐up post‐MMA was 13.7 months (95% CI: 10.1–17.3). All objective outcomes improved significantly; overall, apnea‐hypopnea index (AHI) decreased by −57.3 ([95% CI: −71.5 to −43.2], <jats:italic>p</jats:italic> < 0.0001) lowest oxygen saturation (LSAT) increased by 14.1% ([95% CI: 9.9 to 18.3], <jats:italic>p</jats:italic> < 0.0001), and Epworth Sleepiness Scale (ESS) decreased by −9.4 ([95% CI: −13.5 to −5.2], <jats:italic>p</jats:italic> < 0.0001). Surgical cure was 39.2% (95% CI: 20.3–60.0), and surgical success was 85.6% (95% CI: 77.8–91.5). Comparing percent reduction in class 3 obesity (−92.9%) as compared to class 1 (−85.5%) and class 2 (−83.6%) exhibited a significant difference (1 vs 3 <jats:italic>p</jats:italic> = 0.0012, 2 vs 3 <jats:italic>p</jats:italic> = 0.015).ConclusionsOur findings suggest that MMA significantly improves subjective and objective outcomes in OSA amongst patients with obesity with results comparable to the overall population. Success rates remained above 80% in studies with the highest mean BMI. In addition, patients with class 3 obesity yielded a significantly increased benefit based on percent reduction in AHI compared with class 1 and 2.Level of Evidence1 <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Liao, Mark Lee, Andre Shomorony, Rachel Weitzman, Anthony P. Sclafani
ObjectiveTo understand post‐pandemic interest in plastic surgery procedures via Joinpoint analysis of Google Trends search data.MethodsGoogle Trends was used to quantify search volumes from January 2019–December 2022 for select cosmetic face and body procedures in the United States. A keyword analytic tool (Keywords Everywhere) extracted absolute search volumes (average monthly searches). Joinpoint analysis assessed search trends over time reported as monthly percentage change (MPC).ResultsAll procedures queried, including a non‐cosmetic control (cataract surgery), demonstrated expected declines at the start of the COVID‐19 pandemic. Blepharoplasty, face lift, neck lift, and Botox demonstrated statistically significant increase in search volumes that remained elevated relative to pre‐pandemic levels. Rhinoplasty, fillers, and abdominoplasty interest increased initially followed by return to pre‐pandemic levels by the end of 2022. The remainder of search terms did not show a clear temporal associated with COVID‐19 lockdowns.ConclusionThe “Zoom Boom” appears to be a real phenomenon reflected by sustained increase in public interest in relation to facial plastic procedures.Level of EvidenceNA Laryngoscope, 2024
{"title":"Zoom Boom or Bust? Understanding Post‐Pandemic Interest in Facial Plastic Surgery via Google Trends","authors":"David Liao, Mark Lee, Andre Shomorony, Rachel Weitzman, Anthony P. Sclafani","doi":"10.1002/lary.31753","DOIUrl":"https://doi.org/10.1002/lary.31753","url":null,"abstract":"ObjectiveTo understand post‐pandemic interest in plastic surgery procedures via Joinpoint analysis of Google Trends search data.MethodsGoogle Trends was used to quantify search volumes from January 2019–December 2022 for select cosmetic face and body procedures in the United States. A keyword analytic tool (Keywords Everywhere) extracted absolute search volumes (average monthly searches). Joinpoint analysis assessed search trends over time reported as monthly percentage change (MPC).ResultsAll procedures queried, including a non‐cosmetic control (cataract surgery), demonstrated expected declines at the start of the COVID‐19 pandemic. Blepharoplasty, face lift, neck lift, and Botox demonstrated statistically significant increase in search volumes that remained elevated relative to pre‐pandemic levels. Rhinoplasty, fillers, and abdominoplasty interest increased initially followed by return to pre‐pandemic levels by the end of 2022. The remainder of search terms did not show a clear temporal associated with COVID‐19 lockdowns.ConclusionThe “Zoom Boom” appears to be a real phenomenon reflected by sustained increase in public interest in relation to facial plastic procedures.Level of EvidenceNA <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas Zheng Jie Teng, Pei Yuan Fong, Issam Al Jajeh, Andy Jian Kai Chua
Benign cutaneous apocrine sweat gland adenomas in the nose are rare. We present the novel case of a nasal ala cutaneous sweat gland lesion. A 43‐year‐old male presents with a one year history of a right nostril mass with intermittent clear discharge, triggered by periods of hot weather and increased humidity. Histopathological analysis post‐excision revealed a solid‐cystic lesion of bi‐layered ducts, with snouts suggestive of apocrine secretions. Given the close relationship of tumour enlargement with heat and expression of clear liquid upon direct pressure, we postulate that the intermittent tumescence represents sweat production and accumulation within the lesion. Laryngoscope, 2024
{"title":"Encysted Tubular Sweat Gland Adenoma of the Nasal Ala: A Rare Cause for Unilateral Nasal Discharge","authors":"Thomas Zheng Jie Teng, Pei Yuan Fong, Issam Al Jajeh, Andy Jian Kai Chua","doi":"10.1002/lary.31765","DOIUrl":"https://doi.org/10.1002/lary.31765","url":null,"abstract":"Benign cutaneous apocrine sweat gland adenomas in the nose are rare. We present the novel case of a nasal ala cutaneous sweat gland lesion. A 43‐year‐old male presents with a one year history of a right nostril mass with intermittent clear discharge, triggered by periods of hot weather and increased humidity. Histopathological analysis post‐excision revealed a solid‐cystic lesion of bi‐layered ducts, with snouts suggestive of apocrine secretions. Given the close relationship of tumour enlargement with heat and expression of clear liquid upon direct pressure, we postulate that the intermittent tumescence represents sweat production and accumulation within the lesion. <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander Treble, Jennifer M. Siu, Yasmine Madan, Suzanne Breton, Jackie Chiang, Blake C. Papsin, Evan J. Propst, Nikolaus E. Wolter
ObjectivesNational guidelines advise delaying initiation of solid foods until after 4–6 months of age and avoiding “high‐risk” foods under the age of 4 years. However, foreign body aspiration of food remains a common preventable pediatric emergency. Our primary aim was to investigate public knowledge regarding the safe age of introduction of different foods to children and determine if demographic factors affect this knowledge.MethodsAn online survey was designed following a literature review and consultation with an expert panel. This was distributed via social media platforms. A review of our institutional data of bronchoscopy/foreign body retrievals was performed to identify trends.ResultsThere were 1000 survey responses: 79.4% of respondents cared for children and 21.5% were medical professionals; 37.7% of respondents (n = 385) would offer high‐risk foods to children <2 years of age and 56.9% (n = 582) to children <3 years. At our institution nuts (65.7%) were the most common food‐related foreign body retrieved from a total of 265 over 21 years. Notably, 80% of respondents (n = 800) would offer whole nuts to children <4 years. Respondents with medical training were more likely to hold off on introducing nuts to children until a later age.ConclusionAlthough the public has an overall appreciation of food safety, a significant proportion would feel comfortable offering high‐risk foods to children under 2 and 3 years. There is a poor understanding of the danger of nuts and the appropriate age of introduction. Further research into effective public education strategies on safe food introduction in children are warranted.Levels of EvidenceV Laryngoscope, 2024
{"title":"The Ingestion Question: Public Knowledge of Safe Food Introduction in Children","authors":"Alexander Treble, Jennifer M. Siu, Yasmine Madan, Suzanne Breton, Jackie Chiang, Blake C. Papsin, Evan J. Propst, Nikolaus E. Wolter","doi":"10.1002/lary.31755","DOIUrl":"https://doi.org/10.1002/lary.31755","url":null,"abstract":"ObjectivesNational guidelines advise delaying initiation of solid foods until after 4–6 months of age and avoiding “high‐risk” foods under the age of 4 years. However, foreign body aspiration of food remains a common preventable pediatric emergency. Our primary aim was to investigate public knowledge regarding the safe age of introduction of different foods to children and determine if demographic factors affect this knowledge.MethodsAn online survey was designed following a literature review and consultation with an expert panel. This was distributed via social media platforms. A review of our institutional data of bronchoscopy/foreign body retrievals was performed to identify trends.ResultsThere were 1000 survey responses: 79.4% of respondents cared for children and 21.5% were medical professionals; 37.7% of respondents (<jats:italic>n</jats:italic> = 385) would offer high‐risk foods to children <2 years of age and 56.9% (<jats:italic>n</jats:italic> = 582) to children <3 years. At our institution nuts (65.7%) were the most common food‐related foreign body retrieved from a total of 265 over 21 years. Notably, 80% of respondents (<jats:italic>n</jats:italic> = 800) would offer whole nuts to children <4 years. Respondents with medical training were more likely to hold off on introducing nuts to children until a later age.ConclusionAlthough the public has an overall appreciation of food safety, a significant proportion would feel comfortable offering high‐risk foods to children under 2 and 3 years. There is a poor understanding of the danger of nuts and the appropriate age of introduction. Further research into effective public education strategies on safe food introduction in children are warranted.Levels of EvidenceV <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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