The impacts of earthquakes on the mental health of individuals have been well-documented. Additionally, individuals frequently report experiencing dizziness akin to seasickness or carsickness. This phenomenon, termed “post-earthquake dizziness syndrome” (PEDS), has garnered increasing attention due to its unclear etiology. This study investigates the prevalence and predictors of ongoing PEDS within an adolescent population more than one year after the 2023 Kahramanmaraş earthquakes.
Methods
This cross-sectional study was conducted between April 2024 and June 2024 across five cities officially designated as an “earthquake zone” by relevant authorities. The sample comprised 551 adolescents aged 11 to 18 years who were recruited from child psychiatry outpatient clinics within these cities.
Results
402 participants (73.0 %) reported experiencing PEDS following the earthquake, while 105 (19.1 %) reported ongoing PEDS. Multivariate logistic regression analysis revealed that higher trait anxiety and post-traumatic stress disorder (PTSD) symptoms, as well as being located on a higher floor during the earthquake, were positively correlated with the persistence of PEDS symptoms.
Conclusions
The findings underscore the potential association between PEDS and psychiatric disorders, such as anxiety and PTSD. However, the underlying mechanisms of PEDS remain elusive, requiring further research to elucidate the links between PEDS and psychiatric conditions for more effective treatment strategies.
{"title":"Identifying predictors of persistent post-earthquake dizziness among adolescents after the 2023 earthquakes in Türkiye: A cross-sectional, multicenter study","authors":"Seda Bozduman Çelebi , Berhan Akdağ , Nazmiye İnce , Burak Kamış , Hilal Yazıcı Kopuz , Kübra Gıran , Fethiye Kılıçaslan , Semiha Cömertoğlu Arslan , Hatice Altun , Asiye Arıcı Gürbüz , Çisel Yazan Songür , Hülya Binokay","doi":"10.1016/j.anl.2024.10.013","DOIUrl":"10.1016/j.anl.2024.10.013","url":null,"abstract":"<div><h3>Objective</h3><div>The impacts of earthquakes on the mental health of individuals have been well-documented. Additionally, individuals frequently report experiencing dizziness akin to seasickness or carsickness. This phenomenon, termed “post-earthquake dizziness syndrome” (PEDS), has garnered increasing attention due to its unclear etiology. This study investigates the prevalence and predictors of ongoing PEDS within an adolescent population more than one year after the 2023 Kahramanmaraş earthquakes.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted between April 2024 and June 2024 across five cities officially designated as an “earthquake zone” by relevant authorities. The sample comprised 551 adolescents aged 11 to 18 years who were recruited from child psychiatry outpatient clinics within these cities.</div></div><div><h3>Results</h3><div>402 participants (73.0 %) reported experiencing PEDS following the earthquake, while 105 (19.1 %) reported ongoing PEDS. Multivariate logistic regression analysis revealed that higher trait anxiety and post-traumatic stress disorder (PTSD) symptoms, as well as being located on a higher floor during the earthquake, were positively correlated with the persistence of PEDS symptoms.</div></div><div><h3>Conclusions</h3><div>The findings underscore the potential association between PEDS and psychiatric disorders, such as anxiety and PTSD. However, the underlying mechanisms of PEDS remain elusive, requiring further research to elucidate the links between PEDS and psychiatric conditions for more effective treatment strategies.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1081-1084"},"PeriodicalIF":1.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644880","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}
Eosinophilic otitis media (EOM) is a chronic eosinophilic inflammatory disease linked to bronchial asthma and nasal polyps. EOM is often accompanied by tympanic membrane perforation. Although the primary treatment, steroid therapy, is generally effective, its efficacy may be limited in advanced cases, particularly those involving significant thickening of the middle ear mucosa. Despite its clinical importance, details regarding the pathogenesis of EOM have not been elucidated. Our study aimed to characterize the microbiome associated with EOM and explore changes with and without tympanic membrane perforation.
Methods
We enrolled 27 patients clinically diagnosed with EOM, 25 controls without middle ear infections, and 10 patients with chronic suppurative otitis media (CSOM) [1] [2]. Specimens were collected by swabbing the middle ear, nasopharynx, and external auditory canal (EAC) of subjects in the EOM and control groups, whereas CSOM specimens were collected only from the middle ear. The V3-V4 regions of the 16S ribosomal RNA genes were amplified and subjected to high-throughput sequencing. We evaluated alpha and beta diversity indices between the EOM and control subjects, followed by Linear discriminant analysis Effect Size (LEfSe) analysis to identify potential biomarkers. Additionally, co-occurrence patterns were analyzed to explore the associated microbial interactions. To assess whether similar biomarkers were identified between the EOM and CSOM subjects, LEfSe analysis was conducted for these two groups.
Results
Compared with controls, EOM patients were significantly enriched in Nocardioides in the middle ear, nasopharynx, and EAC, highlighting a distinct microbiological feature. Both alpha and beta diversity were significantly reduced in EOM patients with tympanic membrane perforation. When comparing the EOM and CSOM groups, Nocardioides was consistently identified as a significant biomarker for EOM, confirming its distinct association with EOM. In co-occurrence analysis, Nocardioides showed notable positive co-occurrence with several other genera.
Conclusion
This study reports the first detailed exploration of the EOM microbiome and identified Nocardioides as a new biomarker. The significant shift in microbial co-occurrence associated with tympanic membrane perforation may contribute to the disease's refractory nature, suggesting new avenues for understanding and managing EOM.
{"title":"Characterization of microbial diversity and eosinophilic otitis media biomarkers using next-generation sequencing","authors":"Rieko Ii , Emiko Noguchi , Naoto Adachi , Masanori Kidoguchi , Takako Nakamura , Hidetaka Miyamoto , Yukiko Nishihama , Ayami Nomura , Junko Takahata , Yukihiro Kimura , Masayuki Okamoto , Yuki Hirose , Shuho Tanaka , Shigeharu Fujieda , Atsushi Matsubara , Keiji Tabuchi","doi":"10.1016/j.anl.2024.10.012","DOIUrl":"10.1016/j.anl.2024.10.012","url":null,"abstract":"<div><h3>Objective</h3><div>Eosinophilic otitis media (EOM) is a chronic eosinophilic inflammatory disease linked to bronchial asthma and nasal polyps. EOM is often accompanied by tympanic membrane perforation. Although the primary treatment, steroid therapy, is generally effective, its efficacy may be limited in advanced cases, particularly those involving significant thickening of the middle ear mucosa. Despite its clinical importance, details regarding the pathogenesis of EOM have not been elucidated. Our study aimed to characterize the microbiome associated with EOM and explore changes with and without tympanic membrane perforation.</div></div><div><h3>Methods</h3><div>We enrolled 27 patients clinically diagnosed with EOM, 25 controls without middle ear infections, and 10 patients with chronic suppurative otitis media (CSOM) [1] [2]. Specimens were collected by swabbing the middle ear, nasopharynx, and external auditory canal (EAC) of subjects in the EOM and control groups, whereas CSOM specimens were collected only from the middle ear. The V3-V4 regions of the 16S ribosomal RNA genes were amplified and subjected to high-throughput sequencing. We evaluated alpha and beta diversity indices between the EOM and control subjects, followed by Linear discriminant analysis Effect Size (LEfSe) analysis to identify potential biomarkers. Additionally, co-occurrence patterns were analyzed to explore the associated microbial interactions. To assess whether similar biomarkers were identified between the EOM and CSOM subjects, LEfSe analysis was conducted for these two groups.</div></div><div><h3>Results</h3><div>Compared with controls, EOM patients were significantly enriched in <em>Nocardioides</em> in the middle ear, nasopharynx, and EAC, highlighting a distinct microbiological feature. Both alpha and beta diversity were significantly reduced in EOM patients with tympanic membrane perforation. When comparing the EOM and CSOM groups, <em>Nocardioides</em> was consistently identified as a significant biomarker for EOM, confirming its distinct association with EOM. In co-occurrence analysis, <em>Nocardioides</em> showed notable positive co-occurrence with several other genera.</div></div><div><h3>Conclusion</h3><div>This study reports the first detailed exploration of the EOM microbiome and identified <em>Nocardioides</em> as a new biomarker. The significant shift in microbial co-occurrence associated with tympanic membrane perforation may contribute to the disease's refractory nature, suggesting new avenues for understanding and managing EOM.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1073-1080"},"PeriodicalIF":1.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142636195","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 : 2024-11-06DOI: 10.1016/j.anl.2024.10.001
Chikako Kunieda , Tomohiro Mori , Ujimoto Konomi , Koji Matsushima , Daigo Komazawa , Takeharu Kanazawa
Objective
Ultrasound provides real-time anatomical information and motion. We used ultrasound to image the cricoarytenoid joint and its rotating, rocking, and gliding movements.
Methods
Between March and October 2023, 20 patients (10 males and 10 females) who visited our hospital underwent laryngeal ultrasonography. The joint cavity was delineated in four patients (20 %, two males and two females). Conversely, the other patients did not detect it because of acoustic shadows on ultrasonography. We also performed ultrasonography on five volunteers (three males and two females), but only two of them (two females) showed imaging of the joint cavity. Herein, we report the case of a female volunteer in her 30 s who had the best delineation of joint movements.
Results
Joint movements were three-dimensional, whereas ultrasound images were two-dimensional. However, combined with scanning techniques, characteristic joint movements were successfully imaged using ultrasound. Initially, we performed a trans-thyroid cartilage transversal procedure to visualize the muscular process of the arytenoid cartilage and rotational movement. Subsequently, the probe was rotated to an oblique position, and the articular cavity of the cricoarytenoid joint was visualized. We then observed the rocking and gliding movements. In Addition, we demonstrated a seamless transition from gliding to rocking. Finally, we observed that the arytenoid cartilage was pulled toward the posterior cricoarytenoid muscle (PCA) during sniffing. The PCA is the only muscle opening the vocal cords, so the arytenoid cartilage shifts toward the PCA and tilts outward from the larynx.
Conclusion
The presented probe scanning techniques and specific joint movements may help identify notable conditions such as arthritis or joint dislocation.
{"title":"Ultrasonography of the cricoarytenoid joint and its movements","authors":"Chikako Kunieda , Tomohiro Mori , Ujimoto Konomi , Koji Matsushima , Daigo Komazawa , Takeharu Kanazawa","doi":"10.1016/j.anl.2024.10.001","DOIUrl":"10.1016/j.anl.2024.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>Ultrasound provides real-time anatomical information and motion. We used ultrasound to image the cricoarytenoid joint and its rotating, rocking, and gliding movements.</div></div><div><h3>Methods</h3><div>Between March and October 2023, 20 patients (10 males and 10 females) who visited our hospital underwent laryngeal ultrasonography. The joint cavity was delineated in four patients (20 %, two males and two females). Conversely, the other patients did not detect it because of acoustic shadows on ultrasonography. We also performed ultrasonography on five volunteers (three males and two females), but only two of them (two females) showed imaging of the joint cavity. Herein, we report the case of a female volunteer in her 30 s who had the best delineation of joint movements.</div></div><div><h3>Results</h3><div>Joint movements were three-dimensional, whereas ultrasound images were two-dimensional. However, combined with scanning techniques, characteristic joint movements were successfully imaged using ultrasound. Initially, we performed a trans-thyroid cartilage transversal procedure to visualize the muscular process of the arytenoid cartilage and rotational movement. Subsequently, the probe was rotated to an oblique position, and the articular cavity of the cricoarytenoid joint was visualized. We then observed the rocking and gliding movements. In Addition, we demonstrated a seamless transition from gliding to rocking. Finally, we observed that the arytenoid cartilage was pulled toward the posterior cricoarytenoid muscle (PCA) during sniffing. The PCA is the only muscle opening the vocal cords, so the arytenoid cartilage shifts toward the PCA and tilts outward from the larynx.</div></div><div><h3>Conclusion</h3><div>The presented probe scanning techniques and specific joint movements may help identify notable conditions such as arthritis or joint dislocation.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1068-1072"},"PeriodicalIF":1.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593221","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}
In this post hoc analysis, we aimed to evaluate the efficacy of 1.5% levofloxacin (LVFX) otic solution for the treatment of acute otitis externa (AOE) in patients with nonintact tympanic membrane (NTM) accompanied by chronic suppurative and acute otitis media.
Methods
Digital endoscopic images of the tympanic membrane and cavity were evaluated. In addition, the full analysis set from the original ENT103-3001 study was analyzed to determine the efficacy of the 1.5% LVFX otic solution in treating patients with otitis media with persistent otorrhea. AOE was diagnosed by a study-specific blinded independent review committee (BIRC) in the present study, which reviewed the presence of inflammatory findings, such as edema, erosion, and/or erythema (redness), in the external ear canal on the digital endoscopic images acquired at screening. The improvement in the inflammatory findings in each diseased ear was evaluated by examining the digital endoscopic images acquired at the end of treatment (EOT; including study discontinuation) and follow-up (F/U) visits. Data regarding residual purulent otorrhea at EOT and F/U visits were assessed by the BIRC of the ENT103-3001 study. Similarly, otological symptoms at EOT were recorded in the patients’ diaries, and the bacterial eradication rates were used from the ENT103-3001 study. Improvement was defined as the resolution of the inflammatory findings and purulent otorrhea.
Results
Among the 201 patients with otitis media, 161 patients had AOE (LVFX group, 82; placebo group, 79). The difference (95% confidence interval) between the groups at EOT was 27.3% (12.7, 40.3), and the proportion of patients showing improvement in all inflammatory findings in the external ear canal in the LVFX group (47.6%, 39/82) was significantly higher than that in the placebo group (20.3%, 16/79; Fisher's exact test, p < 0.001). Similarly, the bacterial eradication rate in the LVFX group (94.3%, 66/70) was also significantly higher than that in the placebo group (10.3%, 7/68; Fisher's exact test, p < 0.001).
Conclusion
The use of 1.5% LVFX otic solution resulted in a significantly higher rate of improvement in inflammatory findings in the external ear canal and bacterial eradication rate, indicating its efficacy. Thus, 1.5% LVFX otic solution may be an effective treatment for chronic suppurative otitis media and acute otitis media, as well as AOE with NTM.
{"title":"Efficacy of 1.5% levofloxacin otic solution in treating acute otitis externa: A post hoc analysis of ENT103-3001, a multicenter randomized double-blind parallel-group placebo-controlled phase III study in otitis media with persistent otorrhea","authors":"Han Matsuda , Masafumi Sawada , Kayo Suzuki , Haruo Takahashi , Tetsuo Ikezono","doi":"10.1016/j.anl.2024.10.015","DOIUrl":"10.1016/j.anl.2024.10.015","url":null,"abstract":"<div><h3>Objective</h3><div>In this post hoc analysis, we aimed to evaluate the efficacy of 1.5% levofloxacin (LVFX) otic solution for the treatment of acute otitis externa (AOE) in patients with nonintact tympanic membrane (NTM) accompanied by chronic suppurative and acute otitis media.</div></div><div><h3>Methods</h3><div>Digital endoscopic images of the tympanic membrane and cavity were evaluated. In addition, the full analysis set from the original ENT103-3001 study was analyzed to determine the efficacy of the 1.5% LVFX otic solution in treating patients with otitis media with persistent otorrhea. AOE was diagnosed by a study-specific blinded independent review committee (BIRC) in the present study, which reviewed the presence of inflammatory findings, such as edema, erosion, and/or erythema (redness), in the external ear canal on the digital endoscopic images acquired at screening. The improvement in the inflammatory findings in each diseased ear was evaluated by examining the digital endoscopic images acquired at the end of treatment (EOT; including study discontinuation) and follow-up (F/U) visits. Data regarding residual purulent otorrhea at EOT and F/U visits were assessed by the BIRC of the ENT103-3001 study. Similarly, otological symptoms at EOT were recorded in the patients’ diaries, and the bacterial eradication rates were used from the ENT103-3001 study. Improvement was defined as the resolution of the inflammatory findings and purulent otorrhea.</div></div><div><h3>Results</h3><div>Among the 201 patients with otitis media, 161 patients had AOE (LVFX group, 82; placebo group, 79). The difference (95% confidence interval) between the groups at EOT was 27.3% (12.7, 40.3), and the proportion of patients showing improvement in all inflammatory findings in the external ear canal in the LVFX group (47.6%, 39/82) was significantly higher than that in the placebo group (20.3%, 16/79; Fisher's exact test, <em>p</em> < 0.001). Similarly, the bacterial eradication rate in the LVFX group (94.3%, 66/70) was also significantly higher than that in the placebo group (10.3%, 7/68; Fisher's exact test, <em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>The use of 1.5% LVFX otic solution resulted in a significantly higher rate of improvement in inflammatory findings in the external ear canal and bacterial eradication rate, indicating its efficacy. Thus, 1.5% LVFX otic solution may be an effective treatment for chronic suppurative otitis media and acute otitis media, as well as AOE with NTM.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1060-1067"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To review the various basic research and treatments available to regenerate the vocal folds and to discuss the direction for future treatments.
Methods
A comprehensive review was performed in PubMed database and Google Scholar utilizing search terms including combinations and variations of the following concepts: vocal fold anatomy, vocal fold disorders, and regenerative therapies. No particular inclusion or exclusion criteria were set due to the nature of this narrative review article.
Results/Discussion
The regenerative treatments available for each vocal fold layer are the following: 1) epidermal growth factor and transforming growth factor-β1 for the epithelial layer, 2) autologous fibroblasts, autologous bone-marrow derived mesenchymal stem cells (MSCs), autologous adipose tissue-derived stromal vascular fraction (ADSVF), basic fibroblast growth factor (bFGF), collagen-hyaluronic acid nanofiber, pirfenidone, hepatocyte growth factor (HGF), pulsed dye laser (PDL), diode laser, and platelet-rich plasma (PRP) for the lamina propria, 3) bFGF and controlled-release bFGF with autologous fascia, HGF, c-Met agonistic antibody, and PRP for the muscular layer, 4) and bFGF and PRP-loaded nerve guidance conduit for the nerve. Treatments deemed clinically safe with sustained efficacy assessed up to 6 months are HGF and PDL, while bFGF, autologous fibroblasts, autologous bone marrow-derived MSCs, ADSVF, and PRP have been studied up to 12 months.
Conclusion
An ideal regenerative treatment is one that restores the injured or lost components of the vocal fold. The layered structure of the vocal fold allows for several mechanisms of action for these regenerative therapies. Further experimental and clinical studies are warranted, and these would dictate the impact of vocal fold regenerative therapies. Regenerative medicine may soon be at the forefront for treating vocal fold disorders. Clinicians should be open to advancements in treatment and consider the potential of novel therapies to treat specific pathologies.
{"title":"A narrative review of basic and clinical studies for vocal fold regeneration therapies","authors":"Cathrine Miura , Rumi Ueha , Maria Angela Dealino , Naoyuki Matsumoto , Taku Sato , Takao Goto , Kenji Kondo","doi":"10.1016/j.anl.2024.10.011","DOIUrl":"10.1016/j.anl.2024.10.011","url":null,"abstract":"<div><h3>Objective</h3><div>To review the various basic research and treatments available to regenerate the vocal folds and to discuss the direction for future treatments.</div></div><div><h3>Methods</h3><div>A comprehensive review was performed in PubMed database and Google Scholar utilizing search terms including combinations and variations of the following concepts: vocal fold anatomy, vocal fold disorders, and regenerative therapies. No particular inclusion or exclusion criteria were set due to the nature of this narrative review article.</div></div><div><h3>Results/Discussion</h3><div>The regenerative treatments available for each vocal fold layer are the following: 1) epidermal growth factor and transforming growth factor-β1 for the epithelial layer, 2) autologous fibroblasts, autologous bone-marrow derived mesenchymal stem cells (MSCs), autologous adipose tissue-derived stromal vascular fraction (ADSVF), basic fibroblast growth factor (bFGF), collagen-hyaluronic acid nanofiber, pirfenidone, hepatocyte growth factor (HGF), pulsed dye laser (PDL), diode laser, and platelet-rich plasma (PRP) for the lamina propria, 3) bFGF and controlled-release bFGF with autologous fascia, HGF, c-Met agonistic antibody, and PRP for the muscular layer, 4) and bFGF and PRP-loaded nerve guidance conduit for the nerve. Treatments deemed clinically safe with sustained efficacy assessed up to 6 months are HGF and PDL, while bFGF, autologous fibroblasts, autologous bone marrow-derived MSCs, ADSVF, and PRP have been studied up to 12 months.</div></div><div><h3>Conclusion</h3><div>An ideal regenerative treatment is one that restores the injured or lost components of the vocal fold. The layered structure of the vocal fold allows for several mechanisms of action for these regenerative therapies. Further experimental and clinical studies are warranted, and these would dictate the impact of vocal fold regenerative therapies. Regenerative medicine may soon be at the forefront for treating vocal fold disorders. Clinicians should be open to advancements in treatment and consider the potential of novel therapies to treat specific pathologies.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1052-1059"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to determine the effectiveness of sublingual immunotherapy (SLIT) in preventing the exacerbation of asthma.
Methods
This retrospective study investigated the changes in the rate of continuous steroid inhalation introduced over three years due to SLIT in 328 patients aged 5–15 years who were diagnosed with allergic rhinitis between January 1, 2018, and December 31, 2019. These patients were not initially prescribed with continuous steroid inhalation. SLIT and symptomatic treatment groups were compared over 3 years using chi-square and Fisher's exact tests, controlling for age with multiple regression analysis. The SLIT subgroups and factors contributing to asthma exacerbation were examined as secondary endpoints.
Results
The study comprised 151 patients in the SLIT group and 177 patients in the symptomatic treatment group, with higher average age and IgE levels in the SLIT group. High continuation rates for SLIT were observed over 3 years. Asthma exacerbation within 3 years was notably lower in the SLIT group, particularly in the cedar-only and combined SLIT groups. Multiple regression analysis confirmed the duration of SLIT as a significant factor in preventing asthma exacerbation. Additionally, Fisher's exact test supported these findings.
Conclusion
This study demonstrated the effectiveness of SLIT in reducing the exacerbation of asthma in children with allergic rhinitis. SLIT was associated with lower rates of asthma exacerbation over a three-year period compared to symptomatic treatment.
{"title":"Evaluation of the preventive effect of sublingual immunotherapy for pediatric bronchial asthma","authors":"Takanari Kawabe , Kayoko Kawashima , Yuko Nagai , Mika Okuno , Yukiko Hanada , Tomohiro Yamaguchi , Rumi Ueno , Yuki Tsurinaga , Youhei Fukasawa , Yuri Takaoka , Yukinori Yoshida , Makoto Kameda","doi":"10.1016/j.anl.2024.10.008","DOIUrl":"10.1016/j.anl.2024.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine the effectiveness of sublingual immunotherapy (SLIT) in preventing the exacerbation of asthma.</div></div><div><h3>Methods</h3><div>This retrospective study investigated the changes in the rate of continuous steroid inhalation introduced over three years due to SLIT in 328 patients aged 5–15 years who were diagnosed with allergic rhinitis between January 1, 2018, and December 31, 2019. These patients were not initially prescribed with continuous steroid inhalation. SLIT and symptomatic treatment groups were compared over 3 years using chi-square and Fisher's exact tests, controlling for age with multiple regression analysis. The SLIT subgroups and factors contributing to asthma exacerbation were examined as secondary endpoints.</div></div><div><h3>Results</h3><div>The study comprised 151 patients in the SLIT group and 177 patients in the symptomatic treatment group, with higher average age and IgE levels in the SLIT group. High continuation rates for SLIT were observed over 3 years. Asthma exacerbation within 3 years was notably lower in the SLIT group, particularly in the cedar-only and combined SLIT groups. Multiple regression analysis confirmed the duration of SLIT as a significant factor in preventing asthma exacerbation. Additionally, Fisher's exact test supported these findings.</div></div><div><h3>Conclusion</h3><div>This study demonstrated the effectiveness of SLIT in reducing the exacerbation of asthma in children with allergic rhinitis. SLIT was associated with lower rates of asthma exacerbation over a three-year period compared to symptomatic treatment.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1031-1036"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549158","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}
Endoscopic laryngopharyngeal surgery (ELPS) is a transoral surgery performed for the treatment of early-stage pharyngeal and supralaryngeal cancer. In Japan, ELPS is often chosen for transoral resection of hypopharyngeal cancer. However, in cases of trismus, exposing the hypopharynx even with ELPS using a curved laryngoscope may not be possible. Thus, we developed the percutaneous laryngeal elevation technique (PLET). The PLET is easy to perform because it only requires the addition of a percutaneous suture on the larynx and lifting the larynx ventrally. The PLET could dramatically improve hypopharynx exposure and allow us to perform ELPS on a patient with hypopharyngeal cancer experiencing severe trismus. A 64-year-old man was referred to our hospital for the treatment of hypopharyngeal cancer (cTisN0M0). He had severe trismus because of past surgery and radiotherapy for buccal mucosa cancer. Mouth-opening surgery was performed initially, followed by ELPS. However, the hypopharynx was insufficiently exposed, and the entire tumor could not be visualized. The PLET was performed, which dramatically improved the exposure and allowed us to resect the tumor with sufficient surgical margin. In this case, no intra- and postoperative PLET-related complications were observed. Thus, the PLET is an easy and safe technique for improving hypopharyngeal exposure.
{"title":"Percutaneous laryngeal elevation technique to achieve excellent hypopharyngeal exposure in transoral surgery","authors":"Satoshi Koyama, Toru Kimura, Ryohei Donishi, Kenkichiro Taira, Takahiro Fukuhara, Kazunori Fujiwara","doi":"10.1016/j.anl.2024.10.014","DOIUrl":"10.1016/j.anl.2024.10.014","url":null,"abstract":"<div><div>Endoscopic laryngopharyngeal surgery (ELPS) is a transoral surgery performed for the treatment of early-stage pharyngeal and supralaryngeal cancer. In Japan, ELPS is often chosen for transoral resection of hypopharyngeal cancer. However, in cases of trismus, exposing the hypopharynx even with ELPS using a curved laryngoscope may not be possible. Thus, we developed the percutaneous laryngeal elevation technique (PLET). The PLET is easy to perform because it only requires the addition of a percutaneous suture on the larynx and lifting the larynx ventrally. The PLET could dramatically improve hypopharynx exposure and allow us to perform ELPS on a patient with hypopharyngeal cancer experiencing severe trismus. A 64-year-old man was referred to our hospital for the treatment of hypopharyngeal cancer (cTisN0M0). He had severe trismus because of past surgery and radiotherapy for buccal mucosa cancer. Mouth-opening surgery was performed initially, followed by ELPS. However, the hypopharynx was insufficiently exposed, and the entire tumor could not be visualized. The PLET was performed, which dramatically improved the exposure and allowed us to resect the tumor with sufficient surgical margin. In this case, no intra- and postoperative PLET-related complications were observed. Thus, the PLET is an easy and safe technique for improving hypopharyngeal exposure.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1048-1051"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1016/j.anl.2024.10.005
Chung-Wei Lin , Pei-Wen Lin , Li-Wen Chiu , Mao-Chang Su , Han-Tan Chai , Chun-Tuan Chang , Michael Friedman , Anna M. Salapatas , Hsin-Ching Lin
Objective
Multilevel airway surgery for obstructive sleep apnea/hypopnea syndrome (OSA) has benefits in improving sleep quality, but its effect on polysomnography (PSG) and 6-minute walk test (6MWT) parameters, including walking distance and cardiopulmonary performance, in patients with poor pre-operative cardiopulmonary performance remains understudied, which should be further investigated.
Methods
This prospective pilot study enrolled 27 consecutive OSA patients with poor pre-operative 6MWT results. All patients received multilevel OSA surgery, and the alterations of sleep parameters and 6MWT profiles were studied. The pre- and post-operative values of polysomnographic data and 6MWT profiles were analyzed using the Wilcoxon signed-rank tests. The relationships among changes of the indices of PSG and 6MWT were further investigated with the Spearman's correlations.
Results
After surgery, the sleep parameters and certain cardiopulmonary indices improved. When analyzing the correlations among changes of the indices of PSG and 6MWT, the improvement of daytime sleepiness (with ESS) was found related to farther walking distance (ρ=-0.414, p = 0.032) and higher percentage of “distance/target distance” (ρ=-0.435, p = 0.023). Moreover, the change of maximal expiratory pressure was the only index associated with the changes of AHI (apnea/hypopnea index, /hr.; ρ=-0.407, p = 0.035) and AHI in REM (ρ=-0.502, p = 0.009) among the cardiopulmonary performance parameters.
Conclusion
This pilot study showed that OSA patients with poor pre-operative cardiopulmonary status undergoing multilevel sleep surgery could experience improvement in the sleep study and 6MWT to some extent. The relatively better walking distance and cardiopulmonary performance after the operation might potentially result from the improvement of daytime sleepiness and better respiration.
{"title":"Effects of multilevel OSA surgery on patients with poor cardiopulmonary performance: A prospective pilot study","authors":"Chung-Wei Lin , Pei-Wen Lin , Li-Wen Chiu , Mao-Chang Su , Han-Tan Chai , Chun-Tuan Chang , Michael Friedman , Anna M. Salapatas , Hsin-Ching Lin","doi":"10.1016/j.anl.2024.10.005","DOIUrl":"10.1016/j.anl.2024.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>Multilevel airway surgery for obstructive sleep apnea/hypopnea syndrome (OSA) has benefits in improving sleep quality, but its effect on polysomnography (PSG) and 6-minute walk test (6MWT) parameters, including walking distance and cardiopulmonary performance, in patients with poor pre-operative cardiopulmonary performance remains understudied, which should be further investigated.</div></div><div><h3>Methods</h3><div>This prospective pilot study enrolled 27 consecutive OSA patients with poor pre-operative 6MWT results. All patients received multilevel OSA surgery, and the alterations of sleep parameters and 6MWT profiles were studied. The pre- and post-operative values of polysomnographic data and 6MWT profiles were analyzed using the <em>Wilcoxon signed-rank tests</em>. The relationships among changes of the indices of PSG and 6MWT were further investigated with the <em>Spearman's correlations</em>.</div></div><div><h3>Results</h3><div>After surgery, the sleep parameters and certain cardiopulmonary indices improved. When analyzing the correlations among changes of the indices of PSG and 6MWT, the improvement of daytime sleepiness (with ESS) was found related to farther walking distance (ρ=-0.414, <em>p</em> = 0.032) and higher percentage of “distance/target distance” (ρ=-0.435, <em>p</em> = 0.023). Moreover, the change of maximal expiratory pressure was the only index associated with the changes of AHI (apnea/hypopnea index, /hr.; ρ=-0.407, <em>p</em> = 0.035) and AHI in REM (ρ=-0.502, <em>p</em> = 0.009) among the cardiopulmonary performance parameters.</div></div><div><h3>Conclusion</h3><div>This pilot study showed that OSA patients with poor pre-operative cardiopulmonary status undergoing multilevel sleep surgery could experience improvement in the sleep study and 6MWT to some extent. The relatively better walking distance and cardiopulmonary performance after the operation might potentially result from the improvement of daytime sleepiness and better respiration.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1042-1047"},"PeriodicalIF":1.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523744","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}
Oxidative stress damages cochlear hair cells in vitro. However, the effect of systemic inflammation on hearing loss remains unclear. Growing evidence suggests that malnutrition influences the development of hearing loss. In this study, we aimed to investigate the influence of the Glasgow prognostic score (GPS), which is calculated based on systemic inflammatory responses and malnutrition, on auditory threshold increases in patients with cancer.
Methods
This single-center retrospective cohort study included patients with cancer who underwent standard pure-tone audiometry (PTA) between November 2014 and May 2023. Patients with complete data in their electronic medical records within 90 days before undergoing standard PTA were included. Multivariate analysis was performed using auditory threshold as the response variable. Covariates, including GPS, were obtained from blood data and physical data before standard PTA. The GPS was classified into three levels based on serum albumin and C-reactive protein levels.
Results
Standard PTA was performed 14,868 times in 5,462 patients. Of these, 742 had cancer and 384 met the inclusion criteria. Multivariate analysis revealed that older age, creatinine clearance <60 mL/min, and high GPS significantly increased the auditory threshold at frequencies of 500–8,000 Hz. A history of platinum drug use and male sex increased the auditory threshold at frequencies >4,000 and >2,000 Hz, respectively.
Conclusion
The GPS was independently associated with elevated standard PTA thresholds in patients with cancer. These results suggest an association between malnutrition/chronic inflammation and hearing loss and provide new information for planning clinical research on hearing loss prevention.
{"title":"Relationship between hearing loss and Glasgow prognostic score in patients with cancer","authors":"Shin Matsumoto , Yuki Hirose , Ryota Ishii , Masahiro Nakayama , Kazuki Takahashi , Kento Sasaki , Keitaro Fujii , Keiji Tabuchi","doi":"10.1016/j.anl.2024.10.009","DOIUrl":"10.1016/j.anl.2024.10.009","url":null,"abstract":"<div><h3>Objective</h3><div>Oxidative stress damages cochlear hair cells <em>in vitro</em>. However, the effect of systemic inflammation on hearing loss remains unclear. Growing evidence suggests that malnutrition influences the development of hearing loss. In this study, we aimed to investigate the influence of the Glasgow prognostic score (GPS), which is calculated based on systemic inflammatory responses and malnutrition, on auditory threshold increases in patients with cancer.</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study included patients with cancer who underwent standard pure-tone audiometry (PTA) between November 2014 and May 2023. Patients with complete data in their electronic medical records within 90 days before undergoing standard PTA were included. Multivariate analysis was performed using auditory threshold as the response variable. Covariates, including GPS, were obtained from blood data and physical data before standard PTA. The GPS was classified into three levels based on serum albumin and C-reactive protein levels.</div></div><div><h3>Results</h3><div>Standard PTA was performed 14,868 times in 5,462 patients. Of these, 742 had cancer and 384 met the inclusion criteria. Multivariate analysis revealed that older age, creatinine clearance <60 mL/min, and high GPS significantly increased the auditory threshold at frequencies of 500–8,000 Hz. A history of platinum drug use and male sex increased the auditory threshold at frequencies >4,000 and >2,000 Hz, respectively.</div></div><div><h3>Conclusion</h3><div>The GPS was independently associated with elevated standard PTA thresholds in patients with cancer. These results suggest an association between malnutrition/chronic inflammation and hearing loss and provide new information for planning clinical research on hearing loss prevention.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1037-1041"},"PeriodicalIF":1.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530968","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 : 2024-10-25DOI: 10.1016/j.anl.2024.09.009
Hiroaki Iijima , Akihiro Sakai , Koji Ebisumoto , Mayu Yamauchi , Daisuke Maki , Takanobu Teramura , Kosuke Saito , Aritomo Yamazaki , Toshihide Inagi , Ai Yamamoto , Hiroshi Ashida , Yurina Sato , Shota Sato , Kenji Okami
Objectives
In recent years, there has been a notable increase in syphilis cases in Japan and Western countries. Syphilis, a classic sexually transmitted disease caused by treponemas, presents diagnostic challenges due to its diverse clinical manifestations. This study explores the diagnosis of syphilis in patients treated at our hospital.
Methods
We retrospectively reviewed patients who visited our hospital between April 2015 and March 2024. The review focused on the patients' clinical backgrounds, onset times, symptoms, diagnostic processes, and clinical courses.
Results
Our hospital had 45 cases of syphilis. Forty-five cases of syphilis were diagnosed as syphilis in our hospital (13 cases were diagnosed in the Otolaryngology: ENT department). The median age was 40 years, with a significant male predominance (male-to-female ratio of 34:11). The median duration from the onset of subjective symptoms to syphilis diagnosis was 54 days. The timeframe from the initial clinic visit to diagnosis ranged from 1 to 57 days, with a median of nine days. Notably, 47.5% of the patients reported a history of employment or patronage in the sex industry. 73.3% of patients presented to local clinics with any kind of subjective symptoms, but syphilis was often missed in the differential diagnosis. Patients visiting the ENT department were referred to our hospital with a diagnosis of persistent oral ulcer, oropharyngeal carcinoma and neck lymphadenopathy. Histological and cytological evaluation was performed in 33% of patients, but the diagnosis was often difficult to make. Additionally, some patients initially denied using sex services at their first visit but later disclosed this during subsequent visits to the Department of Infectious Diseases, highlighting the critical role of thorough medical history assessments.
Conclusion
Diagnosing syphilis can be challenging unless the physician specifically suspects it. It is crucial to consider syphilis in cases of pharyngeal mucosal inflammation and neck lymphadenopathy. This study highlights the need for heightened awareness and education regarding the signs and symptoms of syphilis, particularly oropharyngeal and skin findings, to ensure timely diagnosis and treatment.
{"title":"A retrospective analysis of syphilis cases with a focus on otolaryngology at a university hospital","authors":"Hiroaki Iijima , Akihiro Sakai , Koji Ebisumoto , Mayu Yamauchi , Daisuke Maki , Takanobu Teramura , Kosuke Saito , Aritomo Yamazaki , Toshihide Inagi , Ai Yamamoto , Hiroshi Ashida , Yurina Sato , Shota Sato , Kenji Okami","doi":"10.1016/j.anl.2024.09.009","DOIUrl":"10.1016/j.anl.2024.09.009","url":null,"abstract":"<div><h3>Objectives</h3><div>In recent years, there has been a notable increase in syphilis cases in Japan and Western countries. Syphilis, a classic sexually transmitted disease caused by treponemas, presents diagnostic challenges due to its diverse clinical manifestations. This study explores the diagnosis of syphilis in patients treated at our hospital.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients who visited our hospital between April 2015 and March 2024. The review focused on the patients' clinical backgrounds, onset times, symptoms, diagnostic processes, and clinical courses.</div></div><div><h3>Results</h3><div>Our hospital had 45 cases of syphilis. Forty-five cases of syphilis were diagnosed as syphilis in our hospital (13 cases were diagnosed in the Otolaryngology: ENT department). The median age was 40 years, with a significant male predominance (male-to-female ratio of 34:11). The median duration from the onset of subjective symptoms to syphilis diagnosis was 54 days. The timeframe from the initial clinic visit to diagnosis ranged from 1 to 57 days, with a median of nine days. Notably, 47.5% of the patients reported a history of employment or patronage in the sex industry. 73.3% of patients presented to local clinics with any kind of subjective symptoms, but syphilis was often missed in the differential diagnosis. Patients visiting the ENT department were referred to our hospital with a diagnosis of persistent oral ulcer, oropharyngeal carcinoma and neck lymphadenopathy. Histological and cytological evaluation was performed in 33% of patients, but the diagnosis was often difficult to make. Additionally, some patients initially denied using sex services at their first visit but later disclosed this during subsequent visits to the Department of Infectious Diseases, highlighting the critical role of thorough medical history assessments.</div></div><div><h3>Conclusion</h3><div>Diagnosing syphilis can be challenging unless the physician specifically suspects it. It is crucial to consider syphilis in cases of pharyngeal mucosal inflammation and neck lymphadenopathy. This study highlights the need for heightened awareness and education regarding the signs and symptoms of syphilis, particularly oropharyngeal and skin findings, to ensure timely diagnosis and treatment.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1016-1024"},"PeriodicalIF":1.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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