Acta otorrinolaringologica espanola最新文献

英文中文

Parálisis de Bell y COVID-19: un estudio de cohorte con comparación de tasas históricas: comentario

IF 0.9 Q3 OTORHINOLARYNGOLOGY

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otorri.2024.11.001

Hinpetch Daungsupawong , Viroj Wiwanitkit

引用次数: 0

Reconstrucción del labio inferior con el colgajo de Karapandzic o el colgajo de Colmenero: descripción de resultados

IF 0.9 Q3 OTORHINOLARYNGOLOGY

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otorri.2024.10.001

Anna Sumarroca , Carmen Vega , Susana López , Andreas Leidinger , Gabriel Pedemonte , Xavier León , José Miguel Costa-González

Background and objective

Reconstruction of medium and large oncological defects of the lower lip must preserve the functionality and aesthetics of the area and is usually solved with local pedicled flaps, rarely compared between them. The aim of this study is to analyse our case series of lower lip reconstruction using the Karapandzic flap or the Colmenero flap, and to describe their techniques and results.

Materials and methods

We performed a retrospective review of patients who underwent lower lip resection and reconstruction with the Colmenero flap or Karapandzic flap during the period 2015-2022 with a minimum follow-up time of more than one year. The defect size, treatment, complications, reinterventions and final outcome were analysed.

Results

A total of 22 patients underwent surgery: 13 of them were reconstructed with Karapandzic flaps, all bilateral (26 flaps) and with a mean defect size of 4.05 cm (2.9- 6.5 cm); 9 patients were reconstructed with Colmenero flaps, of which 4 bilaterally (13 flaps), with a mean defect size of 4.16 cm (3-7.5 cm). All flaps were viable and all complications (5 among Karapandzic flaps and 4 among Colmenero flaps), mostly minor, were resolved. There were no statistically significant differences between the sizes of the reconstructed defects or between the complications of the 2 flaps. All patients had a total oral intake of food, no speech defects and a good final aesthetic result.

Conclusions

The surgical techniques of lower lip reconstruction with the Karapandzic flap or the Colmenero flap are very reliable, simple in design, with similar and very satisfactory functional and aesthetic results.

背景和目的下唇大中型肿瘤性缺损的重建必须保留该区域的功能性和美观性，通常采用局部带蒂皮瓣解决，很少对两者进行比较。本研究旨在分析我们使用卡拉潘季奇皮瓣或科尔梅内罗皮瓣进行下唇重建的系列病例，并描述它们的技术和效果。材料和方法我们对 2015-2022 年期间接受下唇切除术并使用科尔梅内罗皮瓣或卡拉潘季奇皮瓣进行重建的患者进行了回顾性回顾，随访时间至少超过一年。结果共有 22 名患者接受了手术：其中13名患者采用卡拉潘季奇皮瓣重建，均为双侧（26个皮瓣），平均缺损大小为4.05厘米（2.9-6.5厘米）；9名患者采用科尔梅内罗皮瓣重建，其中4名患者为双侧（13个皮瓣），平均缺损大小为4.16厘米（3-7.5厘米）。所有皮瓣均存活，所有并发症（卡拉潘季奇皮瓣 5 例，科尔梅内罗皮瓣 4 例）均已解决，其中大部分为轻微并发症。重建缺损的大小和两种皮瓣的并发症之间没有明显的统计学差异。结论：使用卡拉潘季奇皮瓣或科尔梅内罗皮瓣重建下唇的手术技术非常可靠，设计简单，具有相似且非常令人满意的功能和美学效果。

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引用次数: 0

Complications after fine-needle aspiration cytology and core-needle biopsy in benign head & neck neoplasms

IF 0.9 Q3 OTORHINOLARYNGOLOGY

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otorri.2024.09.002

Alfonso Rodriguez-Urzay , Maria Landa-Garmendia , Jon Alexander Sistiaga-Suarez , Jose Angel González-Garcá , Ehkiñe Larruscain-Sarasola , Mikel Beristain , Carlos Miguel Chiesa-Estomba

Introduction

Benign neck masses are one of the most common causes of clinical consultation in head & neck (H&N) clinics. Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) have become among the main strategies for the diagnostic work-up of palpable and non-palpable neck lumps. Moreover, numerous studies have established the safety, high diagnostic yield, and added value of image-guided H&N biopsies, which play an important role in diagnosis, staging, and treatment planning, and can obviate the need for surgery for many patients. Nonetheless, despite the success of both techniques, there is a lack of recent studies regarding their safety and associated complication rates.

Material & method

A retrospective analysis was performed of prospective data on patients undergoing ultrasound-guided FNAC or CNB for benign H&N disease (e.g., salivary gland benign tumors, branchial cleft cyst, thyroglossal duct, cyst, lipoma, or neurinoma) between June 2016 and June 2021 in a tertiary university hospital.

Results

Overall, 192 patients were included (105 [54.7%] men and 87 [45.3%] women). The Kolmogorov-Smirnov test indicated that our data were normally distributed (p = 0.452). The mean age of enrolled patients was 54 ± 10 (range: 18–87). The anatomical site most commonly affected was a major salivary gland (74%). Regarding incidence and type of complications, nine (4.7%) patients experienced complications, infection being the most common problem. The risk of complications was highest in patients with branchial cleft cysts who had undergone FNAC (p = 0.028). Overall, the risk of complications was not associated with the type of technique (p = 0.603; OR: 0.942; 95% confidence interval = 0.245–3.624).

Conclusion

According to our results, FNAC and CNB are generally safe and reliable procedures in the diagnostic work-up of H&N lumps. Nevertheless, physicians should be aware of certain risks associated with these procedures.

{"title":"Complications after fine-needle aspiration cytology and core-needle biopsy in benign head & neck neoplasms","authors":"Alfonso Rodriguez-Urzay , Maria Landa-Garmendia , Jon Alexander Sistiaga-Suarez , Jose Angel González-Garcá , Ehkiñe Larruscain-Sarasola , Mikel Beristain , Carlos Miguel Chiesa-Estomba","doi":"10.1016/j.otorri.2024.09.002","DOIUrl":"10.1016/j.otorri.2024.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Benign neck masses are one of the most common causes of clinical consultation in head & neck (H&N) clinics. Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) have become among the main strategies for the diagnostic work-up of palpable and non-palpable neck lumps. Moreover, numerous studies have established the safety, high diagnostic yield, and added value of image-guided H&N biopsies, which play an important role in diagnosis, staging, and treatment planning, and can obviate the need for surgery for many patients. Nonetheless, despite the success of both techniques, there is a lack of recent studies regarding their safety and associated complication rates.</div></div><div><h3>Material & method</h3><div>A retrospective analysis was performed of prospective data on patients undergoing ultrasound-guided FNAC or CNB for benign H&N disease (e.g., salivary gland benign tumors, branchial cleft cyst, thyroglossal duct, cyst, lipoma, or neurinoma) between June 2016 and June 2021 in a tertiary university hospital.</div></div><div><h3>Results</h3><div>Overall, 192 patients were included (105 [54.7%] men and 87 [45.3%] women). The Kolmogorov-Smirnov test indicated that our data were normally distributed (<em>p</em> = 0.452). The mean age of enrolled patients was 54 ± 10 (range: 18–87). The anatomical site most commonly affected was a major salivary gland (74%). Regarding incidence and type of complications, nine (4.7%) patients experienced complications, infection being the most common problem. The risk of complications was highest in patients with branchial cleft cysts who had undergone FNAC (<em>p</em> = 0.028). Overall, the risk of complications was not associated with the type of technique (<em>p</em> = 0.603; OR: 0.942; 95% confidence interval = 0.245–3.624).</div></div><div><h3>Conclusion</h3><div>According to our results, FNAC and CNB are generally safe and reliable procedures in the diagnostic work-up of H&N lumps. Nevertheless, physicians should be aware of certain risks associated with these procedures.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 2","pages":"Pages 71-75"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552427","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}

引用次数: 0

By-pass venoso (vena yugular interna-vena yugular externa) en paciente con vaciamiento radical bilateral

IF 0.9 Q3 OTORHINOLARYNGOLOGY

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otorri.2024.10.005

Diego Tébar Calo , Pablo Verges Fort , Simon Brotons Durban , Ángel Pla Mocholi , Bosco Vendrell Marques

引用次数: 0

The effect of interleukin-33 expression on prognosis in patients with nasopharyngeal carcinoma

IF 0.9 Q3 OTORHINOLARYNGOLOGY

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otorri.2024.01.010

İbrahim Arslan , Hatice Yılmazçoban , Hülya Eyigör , Canan Sadullahoğlu , Derya Salim Kıvrak , Gözde Akgün , Ömer Tarık Selçuk

Introduction

Interleukin-33 (IL-33) is a newly defined inflammatory cytokine that is a member of the interleukin-1 (IL-1) gene family. This cytokine is expressed in structural cells, such as the vascular endothelium, bronchial epithelial cells, keratinocytes, epithelial cells of the stomach, and fibroblastic reticular cells of lymphoid tissues. Several studies suggest that IL-33 plays a role in head-and-neck cancer. The aim of this study was to retrospectively examine IL-33 expression in nasopharyngeal carcinoma (NPC) and to evaluate its relationship between clinicopathological characteristics and prognosis.

Methods

In this monocentric, retrospective analysis, the data of 43 cases diagnosed with primary NPC and 20 cases with normal nasopharyngeal tissue (diagnosed between 2014 and 2020) were evaluated regarding the relationship between the immunohistochemically analyzed IL-33 expression status and corresponding clinicopathological parameters.

Results

The mean age was 56.9 years. The majority (67.4%) of the patients had an early tumor stage (T1–T2). IL-33 expression was positive in 56% of the cases. The five-year overall survival rate was 77% for all patients, 90% for the patients with positive IL-33 expression, and 55% for those without IL-33 expression (p = 0.008, univariate analysis). In multivariate analysis, IL-33 expression was shown to be the only independent prognostic marker for nasopharyngeal carcinoma (p = 0.014).

Conclusion

This retrospective study showed that IL-33 expression could be considered an independent factor affecting positively prognosis in NPC.

{"title":"The effect of interleukin-33 expression on prognosis in patients with nasopharyngeal carcinoma","authors":"İbrahim Arslan , Hatice Yılmazçoban , Hülya Eyigör , Canan Sadullahoğlu , Derya Salim Kıvrak , Gözde Akgün , Ömer Tarık Selçuk","doi":"10.1016/j.otorri.2024.01.010","DOIUrl":"10.1016/j.otorri.2024.01.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Interleukin-33 (IL-33) is a newly defined inflammatory cytokine that is a member of the interleukin-1 (IL-1) gene family. This cytokine is expressed in structural cells, such as the vascular endothelium, bronchial epithelial cells, keratinocytes, epithelial cells of the stomach, and fibroblastic reticular cells of lymphoid tissues. Several studies suggest that IL-33 plays a role in head-and-neck cancer. The aim of this study was to retrospectively examine IL-33 expression in nasopharyngeal carcinoma (NPC) and to evaluate its relationship between clinicopathological characteristics and prognosis.</div></div><div><h3>Methods</h3><div>In this monocentric, retrospective analysis, the data of 43 cases diagnosed with primary NPC and 20 cases with normal nasopharyngeal tissue (diagnosed between 2014 and 2020) were evaluated regarding the relationship between the immunohistochemically analyzed IL-33 expression status and corresponding clinicopathological parameters.</div></div><div><h3>Results</h3><div>The mean age was 56.9 years. The majority (67.4%) of the patients had an early tumor stage (T1–T2). IL-33 expression was positive in 56% of the cases. The five-year overall survival rate was 77% for all patients, 90% for the patients with positive IL-33 expression, and 55% for those without IL-33 expression (<em>p</em> = 0.008, univariate analysis). In multivariate analysis, IL-33 expression was shown to be the only independent prognostic marker for nasopharyngeal carcinoma (<em>p</em> = 0.014).</div></div><div><h3>Conclusion</h3><div>This retrospective study showed that IL-33 expression could be considered an independent factor affecting positively prognosis in NPC.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 2","pages":"Pages 76-82"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552428","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}

引用次数: 0

Otorhinolaryngological manifestations of autoinflammatory diseases. Systematic review

IF 0.9 Q3 OTORHINOLARYNGOLOGY

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otorri.2024.09.001

María Victoria Mallo-Miranda , Carmelo Morales-Angulo

Objectives

To detail the main otorhinolaryngological manifestations of autoinflammatory diseases, aiming to contribute to early diagnosis and treatment.

Data sources

Searches were conducted in PubMed, LILACS, Cochrane Library.

Review methods

A systematic review of the medical literature on autoinflammatory diseases was conducted to identify characteristic head and neck manifestations, using PRISMA criteria. Observational studies or systematic reviews with a minimum of 10 cases per disease were included. Qualitative synthesis and a risk assessment were carried out.

Results

Our review included 29 articles that met the inclusion criteria, with 10 to 486 patients per study. Autoinflammatory diseases with characteristic head and neck manifestations included VEXAS syndrome (auricular, nasal, or laryngotracheal chondritis), NPRL3-AID (hearing loss), NPRL12-AID (cervical lymphadenopathies, hearing loss and oral ulcers), HIDSs syndrome (painful cervical nodes and oral ulcers), haploinsufficiency A20 (oral ulcers), TRAPS (pharyngitis, aphthous stomatitis, periorbital edema, and cervical lymphadenopathies), Behcet’s disease (oral and pharyngeal ulcers), PFAPA syndrome (recurrent tonsillitis, oral ulcers, and painful cervical adenopathies), Kawasaki disease (cervical nodes, pharyngitis and changes in oral mucosa) and undefined periodic fever (pharyngitis, oral ulcers, and painful cervical nodes).

Conclusion

Given their complex diagnosis and unique head and neck manifestations, otolaryngologists must be well-versed in these diseases for early detection and treatment. ENT specialists should consider the possibility of an autoinflammatory disease when encountering symptoms such as auricular, nasal, or laryngeal chondritis, recurrent oral ulcers, painful inflammatory lymphadenopathies, periorbital edema, recurrent pharyngitis, or hearing loss within the context of compatible systemic conditions.

{"title":"Otorhinolaryngological manifestations of autoinflammatory diseases. Systematic review","authors":"María Victoria Mallo-Miranda , Carmelo Morales-Angulo","doi":"10.1016/j.otorri.2024.09.001","DOIUrl":"10.1016/j.otorri.2024.09.001","url":null,"abstract":"<div><h3>Objectives</h3><div>To detail the main otorhinolaryngological manifestations of autoinflammatory diseases, aiming to contribute to early diagnosis and treatment.</div></div><div><h3>Data sources</h3><div>Searches were conducted in PubMed, LILACS, Cochrane Library.</div></div><div><h3>Review methods</h3><div>A systematic review of the medical literature on autoinflammatory diseases was conducted to identify characteristic head and neck manifestations, using PRISMA criteria. Observational studies or systematic reviews with a minimum of 10 cases per disease were included. Qualitative synthesis and a risk assessment were carried out.</div></div><div><h3>Results</h3><div>Our review included 29 articles that met the inclusion criteria, with 10 to 486 patients per study. Autoinflammatory diseases with characteristic head and neck manifestations included VEXAS syndrome (auricular, nasal, or laryngotracheal chondritis), NPRL3-AID (hearing loss), NPRL12-AID (cervical lymphadenopathies, hearing loss and oral ulcers), HIDSs syndrome (painful cervical nodes and oral ulcers), haploinsufficiency A20 (oral ulcers), TRAPS (pharyngitis, aphthous stomatitis, periorbital edema, and cervical lymphadenopathies), Behcet’s disease (oral and pharyngeal ulcers), PFAPA syndrome (recurrent tonsillitis, oral ulcers, and painful cervical adenopathies), Kawasaki disease (cervical nodes, pharyngitis and changes in oral mucosa) and undefined periodic fever (pharyngitis, oral ulcers, and painful cervical nodes).</div></div><div><h3>Conclusion</h3><div>Given their complex diagnosis and unique head and neck manifestations, otolaryngologists must be well-versed in these diseases for early detection and treatment. ENT specialists should consider the possibility of an autoinflammatory disease when encountering symptoms such as auricular, nasal, or laryngeal chondritis, recurrent oral ulcers, painful inflammatory lymphadenopathies, periorbital edema, recurrent pharyngitis, or hearing loss within the context of compatible systemic conditions.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 2","pages":"Pages 116-129"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552433","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}

引用次数: 0

Subcutaneous emphysema secondary to Eustachian tube dilation

IF 0.9 Q3 OTORHINOLARYNGOLOGY

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otorri.2024.07.003

José M. Sala-Vivé Gallego , Laura Acevedo Ortiz , Xavier Galindo Ortegó

引用次数: 0

Evaluation of remote programming of cochlear implants under challenging conditions

IF 0.9 Q3 OTORHINOLARYNGOLOGY

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otorri.2024.10.002

Luis Lassaletta , Miryam Calvino , Isabel Sánchez-Cuadrado , Giovanni Danesi , Ilaria Patelli , Michela Zana , Íñigo Ruiz de Erenchun-Lasa , Manuela del Carmen Zapata , Eva María Muñoz Yuste , Daniel Schaudel , Cherisse Mark , Gionata Conni , Pedro Luis Sarría Echegaray , Guillermo til-Pérez , Isaac David Gutiérrez Pérez , Elena Muñoz Pascual

Introduction and objectives

During the strained period of the COVID-19 pandemic, an international multi-centric clinical pilot study of remote cochlear implant fitting (remote programming) took place with the primary aim of evaluating the satisfaction of patients and practitioners with this procedure.

Materials and methods

Cochlear implant users and clinical practitioners from clinics in Spain and Italy completed a questionnaire to evaluate their experience regarding their satisfaction with the procedure and with its efficacy.

Results

54 responses were collected from 48 users and 42 responses were collected from 9 clinical practitioners. Practitioners were able to perform both remote fitting and remote telemetry. They rated their satisfaction with the procedure highly, with a median value of 9.5/10. Over 90% were satisfied with the results of the procedure, and all who responded would be willing to use remote programming again. Practitioners also rated the technical performance highly. Users rated their satisfaction with the procedure with a median value of 8/10. The great majority of users would be willing to undergo remote programming again (81.3%), and most would recommend the procedure to other users (74%).

Conclusions

Remote programming is a well-received procedure among both clinical practitioners and cochlear implant users, and offers a useful alternative when in-person visits are not practical or not possible, as was the case during the pandemic.

{"title":"Evaluation of remote programming of cochlear implants under challenging conditions","authors":"Luis Lassaletta , Miryam Calvino , Isabel Sánchez-Cuadrado , Giovanni Danesi , Ilaria Patelli , Michela Zana , Íñigo Ruiz de Erenchun-Lasa , Manuela del Carmen Zapata , Eva María Muñoz Yuste , Daniel Schaudel , Cherisse Mark , Gionata Conni , Pedro Luis Sarría Echegaray , Guillermo til-Pérez , Isaac David Gutiérrez Pérez , Elena Muñoz Pascual","doi":"10.1016/j.otorri.2024.10.002","DOIUrl":"10.1016/j.otorri.2024.10.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>During the strained period of the COVID-19 pandemic, an international multi-centric clinical pilot study of remote cochlear implant fitting (remote programming) took place with the primary aim of evaluating the satisfaction of patients and practitioners with this procedure.</div></div><div><h3>Materials and methods</h3><div>Cochlear implant users and clinical practitioners from clinics in Spain and Italy completed a questionnaire to evaluate their experience regarding their satisfaction with the procedure and with its efficacy.</div></div><div><h3>Results</h3><div>54 responses were collected from 48 users and 42 responses were collected from 9 clinical practitioners. Practitioners were able to perform both remote fitting and remote telemetry. They rated their satisfaction with the procedure highly, with a median value of 9.5/10. Over 90% were satisfied with the results of the procedure, and all who responded would be willing to use remote programming again. Practitioners also rated the technical performance highly. Users rated their satisfaction with the procedure with a median value of 8/10. The great majority of users would be willing to undergo remote programming again (81.3%), and most would recommend the procedure to other users (74%).</div></div><div><h3>Conclusions</h3><div>Remote programming is a well-received procedure among both clinical practitioners and cochlear implant users, and offers a useful alternative when in-person visits are not practical or not possible, as was the case during the pandemic.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 2","pages":"Pages 91-98"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552430","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}

引用次数: 0

Vena yugular interna fenestrada atravesada por nervio espinal

IF 0.9 Q3 OTORHINOLARYNGOLOGY

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otorri.2024.09.003

Belén Clemente Cuartero , Pedro Díaz de Cerio Canduela , Ricardo Fernández-Valadés Gámez

引用次数: 0

Postsurgical hypoparathyroidism: Identification of the high-risk patient. A comparison between the ATA protocol and the SEORL-CCC/SEEN consensus

IF 0.9 Q3 OTORHINOLARYNGOLOGY

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otorri.2024.10.004

Miriam García Lerma, Laura Rodrigáñez Riesco, Antonio del Palacio Muñoz, Ricardo Bernáldez Millán, Laura del Río Arroyo, Javier Gavilán Bouzas, Alejandro Castro Calvo

Introduction

Parathyroid hormone (PTH) levels are the most reliable parameter to identify patients with a high risk of post-thyroidectomy hypoparathyroidism. The American Thyroid Association (ATA) developed a consensus where postoperative iPTH (PTHpost) <15 pg/mL suggests a significant risk for hypoparathyroidism. The Spanish Society of Otolaryngology and Head & Neck Surgery (SEORL-CCC) identifies high-risk patients as those with a decrease of preoperative-postoperative PTH levels (PTHdecr) ≥80%. A comparison of the accuracy of both protocols is made.

Materials and methods

An analysis was conducted on all patients who underwent total or completion thyroidectomy over 10 years. A preoperative PTH (PTHpre) and a postoperative PTH (PTHpost) sample were collected. Postsurgical hypoparathyroidism was defined as the presence of hypocalcemia signs or symptoms, or calcium lower than 7 mg/dL in serum levels or 0.95 mmol/L in ionic levels. No patient received treatment without meeting our definition.

Results

711 patients were included. 19% of patients suffered from hypoparathyroidism. The PTHdecr demonstrated a ROC curve with an AUC of 0.98. iPTHpost demonstrated a ROC curve with an AUC of 0.97. The PTHdecr was found to have a statistically superior AUC compared to the PTHpost (p = 0.002). Considering cutoff levels of 80% for iPTHdecr and 15 pg/mL for PTHpost, no statistical differences were found between the sensitivity of both protocols (93% and 95% respectively), but the same cutoff levels showed a superior specificity of PTHdecr (95%) than PTHpost (86%).

Conclusions

SEORL-CCC protocol, which relies on PTHdecr, has demonstrated superior diagnostic accuracy. The cutoff level used showed a superior specificity without sacrificing its sensitivity.

{"title":"Postsurgical hypoparathyroidism: Identification of the high-risk patient. A comparison between the ATA protocol and the SEORL-CCC/SEEN consensus","authors":"Miriam García Lerma, Laura Rodrigáñez Riesco, Antonio del Palacio Muñoz, Ricardo Bernáldez Millán, Laura del Río Arroyo, Javier Gavilán Bouzas, Alejandro Castro Calvo","doi":"10.1016/j.otorri.2024.10.004","DOIUrl":"10.1016/j.otorri.2024.10.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Parathyroid hormone (PTH) levels are the most reliable parameter to identify patients with a high risk of post-thyroidectomy hypoparathyroidism. The American Thyroid Association (ATA) developed a consensus where postoperative iPTH (PTHpost) <15pg/mL suggests a significant risk for hypoparathyroidism. The Spanish Society of Otolaryngology and Head & Neck Surgery (SEORL-CCC) identifies high-risk patients as those with a decrease of preoperative-postoperative PTH levels (PTHdecr) ≥80%. A comparison of the accuracy of both protocols is made.</div></div><div><h3>Materials and methods</h3><div>An analysis was conducted on all patients who underwent total or completion thyroidectomy over 10 years. A preoperative PTH (PTHpre) and a postoperative PTH (PTHpost) sample were collected. Postsurgical hypoparathyroidism was defined as the presence of hypocalcemia signs or symptoms, or calcium lower than 7mg/dL in serum levels or 0.95mmol/L in ionic levels. No patient received treatment without meeting our definition.</div></div><div><h3>Results</h3><div>711 patients were included. 19% of patients suffered from hypoparathyroidism. The PTHdecr demonstrated a ROC curve with an AUC of 0.98. iPTHpost demonstrated a ROC curve with an AUC of 0.97. The PTHdecr was found to have a statistically superior AUC compared to the PTHpost (p=0.002). Considering cutoff levels of 80% for iPTHdecr and 15pg/mL for PTHpost, no statistical differences were found between the sensitivity of both protocols (93% and 95% respectively), but the same cutoff levels showed a superior specificity of PTHdecr (95%) than PTHpost (86%).</div></div><div><h3>Conclusions</h3><div>SEORL-CCC protocol, which relies on PTHdecr, has demonstrated superior diagnostic accuracy. The cutoff level used showed a superior specificity without sacrificing its sensitivity.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 2","pages":"Pages 99-105"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552431","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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