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Otosyphilis: Two case reports and review of the English and Spanish literature of the last 24 years 耳石症:两例病例报告及过去 24 年英语和西班牙语文献综述
IF 0.9 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.otorri.2024.06.003
Montserrat Asensi-Diaz , Carlos Martin Oviedo , Justo Ramon Gomez Martinez , Alejandro Garcia Palomino , Carlos Serra Smith , Victor Asensi
Syphilis has significantly increased its incidence in Europe and North America in the past 20 years. Although rare, sudden hearing loss might be a complication of syphilis infection. We present two cases of otosyphilis seen in our hospitals and review of the English and Spanish literature already published since 2000.
过去 20 年间,梅毒在欧洲和北美的发病率大幅上升。突然丧失听力可能是梅毒感染的并发症之一,尽管这种情况非常罕见。我们介绍了本医院接诊的两例梅毒耳炎病例,并回顾了自2000年以来发表的英文和西班牙文文献。
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引用次数: 0
Resumen ejecutivo de la Guía de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR), Sociedad Española de Medicina de Urgencias y Emergencias (SEMES) y Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello (SEORL-CCC) para el manejo de la vía aérea difícil 西班牙麻醉、复苏和疼痛治疗学会 (SEDAR)、西班牙急诊医学学会 (SEMES) 和西班牙耳鼻咽喉头颈外科学会 (SEORL-CCC) 困难气道处理指南执行摘要。
IF 0.9 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.otorri.2024.03.004
Manuel Á. Gómez-Ríos , José Alfonso Sastre , Xavier Onrubia-Fuertes , Teresa López , Alfredo Abad-Gurumeta , Rubén Casans-Frances , David Gómez-Ríos , José Carlos Garzón , Vicente Martínez-Pons , Marta Casalderrey-Rivas , Miguel Ángel Fernández-Vaquero , Eugenio Martínez-Hurtado , Ricardo Martín-Larrauri , Laura Reviriego-Agudo , Uxía Gutierrez-Couto , Javier García-Fernández , Alfredo Serrano-Moraza , Luis Jesús Rodríguez Martín , Carmen Camacho Leis , Salvador Espinosa Ramírez , Pedro Charco-Mora
The Airway section of the Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR), Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) present the Guidelines for the integral management of difficult airway in adult patients. This document provides recommendations based on current scientific evidence, theoretical-educational tools and implementation tools, mainly cognitive aids, applicable to the treatment of the airway in the field of anesthesiology, critical care, emergencies and prehospital medicine. Its principles are focused on the human factors, cognitive processes for decision-making in critical situations and optimization in the progression of the application of strategies to preserve adequate alveolar oxygenation in order to improve safety and quality of care.
西班牙麻醉、复苏和疼痛治疗学会 (SEDAR)、西班牙急诊和急救医学学会 (SEMES) 以及西班牙耳鼻咽喉头颈外科学会 (SEORL-CCC) 的气道分会发布了成人患者困难气道综合管理指南。该文件提供了基于当前科学证据、理论教育工具和实施工具(主要是认知辅助工具)的建议,适用于麻醉学、重症监护、急诊和院前医疗领域的气道治疗。其原则侧重于人的因素、危急情况下决策的认知过程以及优化策略的应用进展,以保持充分的肺泡氧合,从而提高安全性和护理质量。
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引用次数: 0
Situación actual de la tutoría en la formación especializada en otorrinolaringología en España. ¿Dónde estamos? ¿Hacia dónde queremos ir? 西班牙耳鼻喉科专业培训的指导现状:我们在哪里? 我们想去哪里?
IF 0.9 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.otorri.2024.03.002
Pedro Díaz de Cerio Canduela , Francesc Xavier Avilés Jurado , Julia de Juan Beltrán , Carlos Magri Ruiz , Alfonso Santamaría Gadea , Fernando López

Background and objective

There is great heterogeneity in the methodology and evaluation in specialised health training (SHT) in otorhinolaryngology in our country. The figure of the resident tutor is the cornerstone on which the SHT system is based and the regulation and recognition of this figure varies. This article aims to take a snapshot of the current situation of the SHT in Spain and to describe the activity of tutors.

Materials and methods

During the month of September 2023, a survey was sent in a Google Forms® format through the Spanish Society of Otolaryngology and Head and Neck Surgery. The survey consisted of 8 multiple-choice questions and 4 questions in which they were asked to rank a series of 5 weaknesses, threats, opportunities and strengths selected by the authors, in order to perform a SWOT analysis.

Results

A total of 103 responses were obtained, of which 81 corresponded to accredited tutors. 63% of the tutors indicated that they did not have enough time to carry out their teaching work and 48% did not carry out a regular assessment of their residents. 64% of the tutors believe that the quality of otorhinolaryngology training in Spain is good and 61% are satisfied with their job as tutors. The main weakness was the short duration of the training programme, and the pressure of care was found to be the main threat. An experienced training system was considered the main strength and the creation of a national network of tutors was seen as an opportunity for improvement.

Conclusions

The creation of a common and transversal otorhinolaryngology training pathway for all accredited centres and the creation of a network of mentors and residents are necessary to address the problems of SHT. The role of the tutor must be recognised and reinforced to improve specialist training.
背景和目的在我国,耳鼻咽喉科专业卫生培训(SHT)的方法和评估存在很大差异。住院医师导师是耳鼻咽喉专科医师培训制度的基石,但对住院医师导师的管理和认可程度却不尽相同。本文旨在概述西班牙耳鼻咽喉头颈外科学会的现状,并描述导师的活动情况。材料与方法在 2023 年 9 月期间,通过西班牙耳鼻咽喉头颈外科学会以 Google Forms® 格式发送了一份调查问卷。调查包括 8 个选择题和 4 个问题,其中作者选择了 5 个弱点、威胁、机会和优势进行排序,以便进行 SWOT 分析。结果共收到 103 份回复,其中 81 份回复来自经认证的讲师。63% 的导师表示没有足够的时间开展教学工作,48% 的导师没有对住院医师进行定期评估。64%的导师认为西班牙的耳鼻喉科培训质量良好,61%的导师对自己的导师工作表示满意。主要不足之处是培训课程时间短,护理压力是主要威胁。经验丰富的培训系统被认为是主要优势,而建立全国导师网络则被认为是一个改进的机会。结论为所有获得认证的中心建立一个通用和横向的耳鼻喉科培训途径,以及建立导师和住院医师网络,对于解决 SHT 问题是必要的。导师的作用必须得到认可和加强,以改善专科培训。
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引用次数: 0
Enhancing the coverage and rotation of anterior ethmoidal artery flap for septal perforation closure: Insights from a flap design study 加强用于室间隔穿孔闭合术的乙状前动脉皮瓣的覆盖和旋转:皮瓣设计研究的启示
IF 0.9 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.otorri.2024.06.004
Octavio Garaycochea , Lina Piñeros , Camilo Rodríguez-Van Strahlen , María Jesús Rojas-Lechuga , Isam Alobid

Background and objectives

The anterior ethmoidal artery flap (AEA) is a pedicle endonasal flap frequently used to repair septal perforations (SP). The posterior incision is the most complex to perform. The primary objective was to determine the minimum height of the posterior incision (PI) of an AEA completely cover an anterior septal perforation.

Materials and methods

A cadaveric specimen was sectioned in the sagittal plane and a SP of 1 cm was created anteriorly. The PI of the AEA flap was made progressively at a height of 10, 20, 30, and 40 mm. The complete closure of the SP and the angle of rotation (AR) of the flap were assessed.

Results

According to the length of the PI the following results were obtained: PI = 10 mm: The SP was covered partially, and the AR was 45º. PI = 20 mm: The SP was fully covered, and the AR was 63º.
PI = 30 mm and 40 mm: The SP was fully covered with redundant tissue.
This study shows that an anterior ethmoidal artery flap that includes the nasal floor and the inferior meatus mucosa combined with a posterior incision of 20 mm could result in adequate coverage of all margins of an anterior SP up to area 1a of the septum.
背景和目的乙状前动脉皮瓣(AEA)是一种常用于修复鼻中隔穿孔(SP)的有蒂鼻内皮瓣。后部切口的操作最为复杂。研究的主要目的是确定完全覆盖鼻中隔前部穿孔的 AEA 后方切口(PI)的最小高度。在 10、20、30 和 40 毫米的高度上逐步制作 AEA 皮瓣的 PI。结果根据 PI 的长度得出以下结果:PI=10毫米:SP被部分覆盖,AR为45º。PI = 20 毫米:PI = 30 毫米和 40 毫米:这项研究表明,乙状动脉前皮瓣包括鼻底和下肉眼黏膜,结合 20 毫米的后切口,可以充分覆盖前 SP 的所有边缘,直至鼻中隔的 1a 区域。
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引用次数: 0
Retrolabyrinthine approach to the lateral skull base: The value of preoperative temporal bone CT analysis 外侧颅底的迷路入路:术前颞骨 CT 分析的价值
IF 0.9 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.otorri.2024.03.001
Fabrizio Salvinelli , Francesca Bonifacio , Carlo A. Mallio , Andrea Pescosolido , Giulia Chiappino , Fabio Greco , Maurizio Iacoangeli

Purpose

The most used neurosurgical approach to reach cerebellar-pontine angle is the retrosigmoid route. This article describes the presigmoid approach which requires excellent knowledge of the labyrinthine block together with quantitative analysis of temporal bone CT.

Methods

CT-based quantitative measurements were obtained in patients undergoing vestibular neurectomy with a presigmoid approach. Eighteen patients were enrolled, and five measures were taken: Trautmann’s area, the petro-clival angle, presigmoid dura length and its angle. The relationship between these measurements and hospitalization days, operating times, and complications was explored.

Results

The posterior semicircilar canal (PSC)-sigmoid sinus (SS) distance, presigmoid dura- internal auditory canal (IAC)-PSC angle, and duration of surgery are predictors of complications. Specifically, a PSC-sigmoid sinus distance <11 mm, a dura presig-IAC-PSC angle <14 are associated with the highest risk of complications.

Conclusion

Preoperative temporal bone CT scan can guide the surgeon through the narrowest areas of the surgical approach. Trautmann’s triangle area and petro-clival angle reduction are challenging and can be faced with combined microscopic-endoscopic technique, and with optics angulation-rotation. The retrolabyrinthine approach can enable hearing preservation and minimal cerebellar retraction.
目的 达到小脑-桥脑角的最常用神经外科方法是后穹隆途径。本文介绍了蝶骨前入路,该方法需要对迷宫阻滞有充分的了解,同时需要对颞骨 CT 进行定量分析。方法对采用蝶骨前入路进行前庭神经切除术的患者进行基于 CT 的定量测量。共招募了 18 名患者,进行了五项测量:Trautmann面积、瓣-瓣角、蝶骨前硬脑膜长度及其角度。结果后半环管(PSC)-乙状窦(SS)距离、乙状硬膜前硬膜-内耳道(IAC)-PSC角度和手术时间是并发症的预测因素。具体来说,PSC-乙状窦距离<11 mm、硬脑膜前-内耳道(IAC)-PSC角度<14与并发症的最高风险相关。Trautmann三角区和瓣隙角缩小具有挑战性,可通过显微镜-内窥镜联合技术和光学角度旋转来解决。迷宫后入路可以保留听力,并将小脑回缩减至最小。
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引用次数: 0
Harpoon-marking of deep tongue foreign body for surgical removal 用鱼叉标记舌深部异物,以便手术取出
IF 0.9 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.otorri.2024.06.002
Sara Costa , Liliana Igreja , Telma Feliciano
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引用次数: 0
Recurrent peritonsillar abscess in adults: Incidence and risk factors in a prospective longitudinal cohort 成人复发性腹股沟周围脓肿:前瞻性纵向队列中的发病率和风险因素
IF 0.9 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.otorri.2024.06.001
Alejandro Portillo-Medina , Mireia Golet Fors , Anna Penella Prat , Manel Manos , Sebastian Videla , Xavier González-Compta

Objective

The incidence of recurrent peritonsillar abscess (7.4–22%) was estimated in retrospective studies. The aim of this prospective study was to estimate the cumulative incidence of recurrent peritonsillar abscess and related risk factors.

Methods

We performed a prospective longitudinal cohort study. The study included adult patients (≥18 years old) of both sexes who were attended in the emergency facilities of our tertiary hospital, without peritonsillar abscess background, diagnosed of a first episode of peritonsillar abscess and treated with standard of care (abscess drainage and antibiotics). Patients were followed for 24 months. Cumulative incidence of peritonsillar abscess recurrence was estimated and its 95% confidence interval was calculated; and predictive risk factors were assessed.

Results

Between January 1st, 2019 and March 9th, 2020, a total of 181 consecutive patients were included. The cumulative incidence of recurrent peritonsillar abscess at 2 years of the diagnosis was 9.9% (18 out of 181, 95% CI: 6.4–15.2%). The only risk factor associated with recurrent peritonsillar abscess in multivariate analysis was low plasma glucose level at the time of emergency room attendance (HR: 0.46, 95% CI: 0.24–0.91, p-value: 0.026).

Conclusion

Peritonsillar abscess is an incident medical issue, with an established recurrence rate, but with unclear predictive risk factors of recurrence. Further studies are needed to assess the risk factor associated with recurrent peritonsillar abscess.
目的 回顾性研究估计了复发性腹腔镜周围脓肿的发病率(7.4%-22%)。本前瞻性研究旨在估算复发性腹腔镜周围脓肿的累积发病率及相关风险因素。研究对象包括在我院三级医院急诊设施就诊的成年男女患者(≥18 岁),他们均无腹腔镜脓肿背景,被诊断为首次腹腔镜脓肿并接受了标准护理(脓肿引流和抗生素)。对患者进行了 24 个月的随访。结果在2019年1月1日至2020年3月9日期间,共纳入了181名连续患者。确诊2年后,腹腔镜周围脓肿复发的累计发生率为9.9%(181例中有18例,95% CI:6.4-15.2%)。在多变量分析中,唯一与腹腔周围脓肿复发相关的风险因素是急诊就诊时血浆葡萄糖水平低(HR:0.46,95% CI:0.24-0.91,P 值:0.026)。需要进一步研究来评估与腹腔镜周围脓肿复发相关的风险因素。
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引用次数: 0
Prevalencia de apnea obstructiva del sueño en pacientes obesos candidatos a cirugía bariátrica y cuestionarios predictores 减肥手术肥胖患者中阻塞性睡眠呼吸暂停的患病率及预测问卷。
IF 0.9 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.otorri.2024.05.003
Silvia Matarredona Quiles , Marina Carrasco Llatas , Paula Martínez Ruíz de Apodaca , Jose Ángel Díez Ares , Sergio Navarro Martínez , José Dalmau Galofre

Introduction and objectives

Obstructive sleep apnea (OSA) is a prevalent condition among electable to bariatric surgery obese patients, often remaining underdiagnosed, thereby increasing surgical risk. The main purpose was to determine prevalence of OSA among candidates for bariatric surgery and to assess the rate of underdiagnosis of this condition. Additionally, the study aimed to evaluate the specific performance of three sleep questionnaires and scales (Excessive Daytime Sleepiness Scale (EDSS), Epworth Sleepiness Scale (ESS), and STOP-Bang) in these patients.

Methods

A longitudinal, prospective, single-cohort study, with consecutive sampling including patients aged 18-65 years with obesity grade II (body mass index (BMI)  35 kg/m2) and hypertension, type 2 diabetes, metabolic syndrome or OSA or obesity grade III or IV (BMI  40 kg/m2) elective for bariatric surgery. Patients were evaluated at the Otorhinolaryngology department with an anamnesis regarding OSA including the administration of three sleep questionnaires (EDSS, ESS, and STOP-Bang), followed by cardiorespiratory polygraphy (CRP) for sleep evaluation.

Results

124 patients were included in this study. While 74.2% of the sample exhibited OSA on CRP, only 28.2% had a prior diagnosis. The STOP-Bang questionnaire demonstrated the highest sensitivity (93.3%) for detecting moderate to severe OSA, although with low specificity (33.8%). EDSS and ESS did not show a significant association with the presence of OSA.

Conclusions

OSA screening is crucial in candidates for bariatric surgery due to its high prevalence and low diagnosis rate. The STOP-Bang questionnaire may serve as a useful tool for identifying patients at risk of moderate to severe OSA and optimizing sleep assessments. However, further research is necessary to validate its utility in this specific population.
导言和目的阻塞性睡眠呼吸暂停(OSA)是可选择进行减肥手术的肥胖患者中的一种普遍病症,往往诊断不足,从而增加了手术风险。研究的主要目的是确定 OSA 在减肥手术候选者中的患病率,并评估该疾病的漏诊率。此外,该研究还旨在评估三种睡眠问卷和量表(日间过度嗜睡量表(EDSS)、埃普沃斯嗜睡量表(ESS)和STOP-Bang)在这些患者中的具体表现。方法一项纵向、前瞻性、单队列研究,连续取样包括 18-65 岁肥胖等级 II(体重指数 (BMI) ≥ 35 kg/m2)和高血压、2 型糖尿病、代谢综合征或 OSA 或肥胖等级 III 或 IV(体重指数 (BMI) ≥ 40 kg/m2)的减肥手术择期患者。患者在耳鼻喉科接受评估,并提供有关 OSA 的病史资料,包括进行三项睡眠问卷调查(EDSS、ESS 和 STOP-Bang),然后进行心肺聚光仪(CRP)睡眠评估。虽然 74.2% 的样本在 CRP 中显示有 OSA,但只有 28.2% 的样本曾被诊断过。STOP-Bang 问卷检测中重度 OSA 的灵敏度最高(93.3%),但特异性较低(33.8%)。结论 由于 OSA 的高患病率和低诊断率,因此对减肥手术患者进行 OSA 筛查至关重要。STOP-Bang 问卷可作为一种有用的工具,用于识别有中度至重度 OSA 风险的患者并优化睡眠评估。不过,还需要进一步的研究来验证其在这一特定人群中的实用性。
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引用次数: 0
Resección de paraganglioma timpánico izquierdo mediante láser fotoangiolítico azul 用蓝色光血管激光切除左侧鼓室旁神经节瘤
IF 0.9 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-11-01 DOI: 10.1016/j.otorri.2024.05.004
María del Mar Martínez Ruiz-Coello , Victoria García Peces , Ramón González Herranz , Guillermo Plaza Mayor
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引用次数: 0
Utilidad de la sialoendoscopia en el manejo de la parotiditis recurrente juvenil. Estudio retrospectivo 咽内镜在治疗青少年复发性腮腺炎中的作用。回顾性研究
IF 0.9 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-09-01 DOI: 10.1016/j.otorri.2024.05.006
Maider Andueza Guembe, Carlos Miguel Chiesa Estomba, Carlos Saga Gutiérrez, Izaskun Thomas Arrizabalaga, Marta Ábrego Olano, María Vázquez Quintano, Xabier Altuna Mariezcurrena

Introduction

Juvenile recurrent parotitis is a rare disease characterized by repeated episodes of inflammation affecting, unilaterally or bilaterally, the parotid glands during childhood.

Material and methods

Retrospective study including patients diagnosed with juvenile recurrent parotitis between January 2010 and September 2020 at a tertiary level hospital, with the aim of evaluating the results of medical treatment and sialoendoscopy.

Results

A total of 48 patients met the inclusion criteria and had a mean follow-up of 4 years (SD = 3; Min: 2/Max: 12). Regarding treatment, 34 (70.8%) patients received conservative treatment and had a mean of 5 episodes (SD = 3; Min: 2/Max: 13) until symptom resolution. Meanwhile, 14 (29.2%) patients underwent sialoendoscopy, of which two (12%) required reintervention. In 100% (14) of the patients treated with siaolendoscopy, the findings were consistent with JRP and, after sialoendoscopy, a statistically significant reduction in episodes was observed, with a mean of 1 post-intervention episode (SD = 1.5; Min:0/Max: 6; P<.001).

Conclusions

The results obtained in this study suggest that sialoendoscopy is a useful tool in the treatment of juvenile recurrent parotitis. However, new studies comparing the results of sialoendoscopy with other therapeutic alternatives are necessary.

材料和方法回顾性研究包括 2010 年 1 月至 2020 年 9 月期间在一家三级医院确诊为幼年复发性腮腺炎的患者,目的是评估药物治疗和咽内镜检查的结果。结果共有 48 名患者符合纳入标准,平均随访 4 年(SD = 3;最少:2/最多:12)。在治疗方面,34 例(70.8%)患者接受了保守治疗,平均治疗 5 次(SD = 3;最少:2 次/最多:13 次),直至症状缓解。同时,14 名(29.2%)患者接受了咽内窥镜检查,其中 2 名(12%)患者需要再次接受治疗。在接受虹膜内镜检查的 14 名患者中,100% 的患者的检查结果与 JRP 一致,而且在接受虹膜内镜检查后,发作次数明显减少,平均减少 1 次(SD = 1.5;最少:0/最多:6;P<.001)。然而,有必要进行新的研究,将咽内窥镜检查结果与其他治疗方法进行比较。
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引用次数: 0
期刊
Acta otorrinolaringologica espanola
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