Hno最新文献

Scientific progress in the diagnosis and treatment of dizziness syndromes has led to a paradigm shift in diagnostic approaches, establishment of a unified international vocabulary, and standardized criteria. Objective methods, including vestibular evoked myogenic potentials and the video head impulse test, are now widely used in otorhinolaryngologic assessments. According to these advancements, new evaluation criteria based on objective measures have been developed. These provide greater clarity in the legal context compared to previous evaluations which were based primarily on subjective standards, thus making the assessments more plausible and comprehensible. It is now possible to definitively substantiate a defined health disorder or functional impairment in the field of otorhinolaryngology with full evidence based on objective criteria.

Disorders of olfaction are a frequent reason for an assessment in otorhinolaryngology. Particularly when the results of subjective and/or objective olfactometry are inconclusive, additional objective findings are required to verify disorders of the sense of smell. Based on practical experience and considering the current literature, this article is intended as an aid in the preparation of supplementary radiological reports. The importance of comprehensive up to date standard imaging including olfactory bulb volumetry in addition to a detailed medical history and, if applicable, previous findings should be emphasized. In addition to the documentation of alterations in the anatomical structures involved in olfaction, which support the reported disorders in the sense of smell, special neuroradiological examination sequences for the visualization of the olfactory bulb, including a volumetric measurement of the same, can provide an objective component for the assessment of sometimes only subjectively existing disorders of the sense of smell. In the majority of cases no valid comparative volumetry can be derived from a possibly pre-existing imaging study. Therefore, a comparison with olfactory bulb reference values, determined in studies for the presumed etiology and the extent of the disorder reported/determined by olfactometry is the only way to put the olfactory bulb volume in an almost objective relationship to the function of the sense of smell reported and/or determined by olfactometry.

The human microbiome consists of a diverse array of microorganisms that perform essential functions for health. In particular, the oral microbiome plays a crucial role in maintaining oral health by preventing the colonization of pathogenic bacteria and regulating pH balance. Dysbiosis of the oral microbiome has been linked to the development of caries, periodontal diseases and oral squamous cell carcinoma. Moreover, a bidirectional interaction between the oral and intestinal microbiomes is mediated through the so-called oral-gut axis. In recent years, prebiotics, probiotics and especially postbiotics have been extensively studied for their potential in microbiome modulation. Postbiotics represent a promising alternative as they do not contain viable microorganisms but bioactive metabolites, cell wall fragments or enzymes that exert immunomodulatory, anti-inflammatory and antimicrobial effects. Particularly in the context of oral health, postbiotics show potential benefits by inhibiting the growth of pathogenic microbes, regulating immune responses and reducing inflammatory processes. Recent research results suggest that postbiotics can sustainably improve oral health. Furthermore, preliminary studies indicate their potential application as an adjunct therapy for oral cancer due to their antitumor properties.

Microbiome research in the ear nose and throat (ENT) field has substantially gained in importance in recent decades. Modern sequencing methods have largely replaced traditional cultivation. Standardized protocols are essential to ensure reliable and comparable data. The article explains key terms, such as microbiome (the entire microbial community and its environment) and microbiota (only living microorganisms), along with the microbial taxonomy. Important measures for microbiome assessment include the alpha-diversity (species richness and distribution within a sample) and beta-diversity (differences between samples). A differentiation is made between two main approaches to microbiome sequencing: 1) 16S rRNA gene amplicon sequencing (identifies microbial community composition by sequencing the PCR product of a specific gene), 2) metagenomic sequencing (sequences the entire genomic material of a sample, allowing deeper insights). As nasal microbiome biomass is low, careful study design and controls are crucial. Microbiome research is a rapidly growing field with great potential but it requires meticulous planning and bioinformatics expertise for meaningful results.

The nasal microbiome refers to the composition and diversity of bacterial communities residing in the nasal cavity. While the gut microbiome has been the primary focus of microbiome research in recent years, driven by advances in diagnostic technologies, increasing attention is now being directed toward microbial ecosystems in other regions of the body, including the respiratory tract. In general, a high and stable microbial diversity (α-diversity) is considered indicative of a "healthy" microbial community. Conversely, reduced bacterial diversity has been associated with clinical conditions, such as chronic rhinosinusitis (CRS); however, it remains unclear whether such microbial alterations are a cause or consequence of the disease, as current evidence does not yet allow for definitive conclusions. Interpreting existing studies on the nasal microbiome is challenging due to several factors: the low microbial biomass in the nasal cavity, the technical difficulty of accurately analyzing such samples, and the lack of standardized methodologies for sampling and data interpretation. These limitations contribute to the heterogeneity of current findings and highlight the need for consistent, guideline-based research protocols in this emerging field.

Breastmilk is well established as the best source of nutrition for infants. Any interruption to breastfeeding comes with risks such as mastitis, decreased breastmilk supply, infant bottle refusal, and infant allergic reaction if formula is used. The majority of common medications used in general otolaryngology are safe for breastfeeding patients. Insufficient knowledge can lead to clinicians and patients alike being concerned about continued breastfeeding, resulting in interruption or cessation of breastfeeding. On the other hand, much-needed treatment is often withheld for fear of putting the infant at risk from contaminated breastmilk, which can disrupt the mother's wellbeing and, in turn, disturb a successful breastfeeding relationship. The aim of the present work is to present a structured "guideline for practice" pertaining to medication that can be used during lactation for treating medical conditions of the ear, nose, and throat.

Vertigo and dizziness are common key symptoms in clinical practice and can significantly impair quality of life. Potential consequences include inability to work, reduced social contacts, falls, and secondary illnesses. Otorhinolaryngologists encounter both acute and chronic dizziness syndromes in emergency settings, during interdisciplinary diagnostic testing, and in ENT expert assessments. A structured medical history, targeted communication techniques, and an orienteering initial examination facilitate differential diagnostic classification. In addition, instrumental, objective diagnostics ("mapping" all five vestibular sensors on both sides) provide quantitative insights into the function of vestibular sensors and reflexes. Although diagnostic criteria and evidence-based treatments exist for certain conditions, the overall data situation remains inadequate for many diseases.

Background: Individual cognitive abilities are increasingly discussed as a potential factor influencing the outcomes of cochlear implant (CI) treatment. In this context, the present study investigated a possible correlation between the secondary and post-secondary education of a large cohort of CI recipients and their speech comprehension. Other variables with a potential influence on the treatment outcome included age at implantation, the duration of hearing loss, and the treatment mode.

Methods: The study included data of n = 326 patients from the audiology database of the Frankfurt University ENT Clinic. Secondary and post-secondary education histories were collected as part of the anamnesis using a questionnaire. Speech comprehension was assessed using the Freiburg monosyllabic test (FBE) and the Oldenburg sentence test in noise (OLSA) at 6 and 12 months after implantation and correlated with various biographical and audiological factors.

Results: Patients with higher educational qualifications showed better outcomes in the FBE at 6 months (ANOVA_Welch; F (2, 104) = 5.60; p = 0.05) and at 12 months (F (2, 223) = 3.07; p = 0.05; η² = 0.03) compared to those with vocational qualifications. In the speech comprehension in noise (OLSA), a significant group difference was observed 12 months postoperatively. Patients without qualifications or with other qualifications scored lower than those with vocational or higher qualifications (F (2, 74) = 4.41; p = 0.02; η² = 0.11). Other significant factors influencing speech comprehension included the age at implantation and mode of care.

Conclusion: The correlation between secondary and post-secondary education and speech comprehension after CI treatment was not unequivocal. Only the choice of post-secondary education showed a significant correlation with speech comprehension. Further research is required to confirm a potential relationship.