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Eficacia del neurofeedback como tratamiento para personas con tinnitus subjetivo en la reducción del síntoma y de las consecuencias relacionadas: una revisión sistemática del 2010 al 2020 神经反馈作为主观耳鸣患者治疗方法在减少症状和相关后果方面的有效性:2010年至2020年的系统回顾
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-07-01 DOI: 10.1016/j.otorri.2022.06.001
Fabiola Varela Barrenechea

Background and objective

Tinnitus is a symptom experienced by millions of people around the world, generating psychological, physical, and social consequences. There are different therapeutic options that seek to reduce the symptom and the related consequences. One of the newest alternatives is training with Neurofeedback, a neuromodulation technique that looks for modify brain activity. The objective of this research was to determine the efficacy of Neurofeedback treatment parameters in reducing the perception of tinnitus and in reducing the behavioral consequences triggered by the symptom, through a systematic review between 2010 and 2020.

Materials and methods

The data search was carried out in Spanish and English on PubMed/MedLine, EBSCO Host, Embase, Scopus, CENTRAL, SpringerLink and OpenGrey databases. The systematic review was carried out according to the stages established by PRISMA and five studies were identified to be included in the qualitative analysis.

Results

All studies demonstrated that NFB training for tinnitus decreases symptom perception and related consequences. At the neural level, there was an increase in the activity of the alpha wave and a decrease in the activity of delta, gamma, and beta.

Conclusions

Neurofeedback has a modulating effect on brain activity patterns. However, although all the studies reported a decrease in the consequences related to the symptom at the behavioral level after treatment, due to the lack of development of this technique for the symptom and the characteristics of the studies reviewed, it cannot be certainty of efficacy on behavioral and neurophysiological consequences.

背景和目的耳鸣是全世界数百万人经历的一种症状,会产生心理、身体和社会后果。有不同的治疗方案可以减少症状和相关后果。最新的替代方案之一是使用神经反馈训练,这是一种神经调控技术,旨在改变大脑活动。本研究的目的是通过2010年至2020年的系统综述,确定神经反馈治疗参数在减少耳鸣感知和减少症状引发的行为后果方面的疗效。材料和方法在PubMed/MedLine、EBSCO Host、Embase、Scopus、CENTRAL、,SpringerLink和OpenGrey数据库。根据PRISMA确定的阶段进行了系统审查,并确定了五项研究纳入定性分析。结果所有研究表明,耳鸣的NFB训练可以降低症状感知和相关后果。在神经水平上,阿尔法波的活性增加,德尔塔、伽马和贝塔波的活性减少。结论神经反馈对大脑活动模式具有调节作用。然而,尽管所有研究都报告了治疗后在行为层面上与症状相关的后果有所减少,但由于缺乏针对症状的这项技术的开发和所审查研究的特点,它不能确定对行为和神经生理学后果的疗效。
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引用次数: 0
Thyroglossal duct cyst carcinoma case series—Management strategy and outcomes 舌骨管囊肿癌病例系列——治疗策略和疗效
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-07-01 DOI: 10.1016/j.otorri.2022.05.002
Aleix Rovira , Aina Brunet , Jean Pierre Jeannon , Paul V. Carroll , Phil Touska , Fahim Hassan , Ann Sandison , Ricard Simo

Objective

To review the clinical presentation, diagnosis, pathology and management strategies in a modern cohort of patients with thyroglossal duct cyst carcinoma.

Study design

Retrospective case series following PROCESS Guidelines.

Setting

Comprehensive cancer centre.

Methods

Data recorded included: gender, age at diagnosis, clinical presentation, thyroid function, diagnostic investigations, cytological results, final histology, staging and follow up status. The risk of malignancy in cytological analysis was stratified according to the Royal College of Pathologists classification in United Kingdom.

Results

Twelve patients were included. The majority of patients (66.7%) presented with an isolated thyroglossal duct cyst. Only 4 patients had preoperative cytological suspicion of carcinoma (sensitivity: 33.3%). At the time of presentation all patients were euthyroid. Following diagnosis of malignancy, a total thyroidectomy was performed in all patients, with the exception of 2, who had a thyroglossal duct cyst carcinoma of less than 10 mm. Among the 10 patients who underwent total thyroidectomy, 7 (70%) patients had proven carcinoma in the thyroid gland, 3 with deposits of less than 10 mm. The average size of the thyroid cancer deposits was 7.2 mm (1–20 mm). With a mean follow-up of is 44 months (5–120), all patients were alive and free of recurrence at the end of the study period.

Conclusion

Thyroglossal duct cyst carcinoma is a rare condition and its management should be discussed in a multidisciplinary meeting. As with differentiated thyroid cancer originating in the thyroid gland, it bears extraordinary survival rates. Accordingly, the management of these cancers has shifted towards a more conservative approach although its peculiarities must be taken into account: ease of extracystic invasion and possible different lymph node invasion.

目的回顾甲状舌管囊肿癌的临床表现、诊断、病理和治疗策略。研究设计回顾性病例系列,遵循过程指南。建立癌症综合中心。方法记录的数据包括:性别、诊断时的年龄、临床表现、甲状腺功能、诊断调查、细胞学结果、最终组织学、分期和随访情况。细胞学分析中恶性肿瘤的风险根据英国皇家病理学家学院的分类进行分层。结果纳入了五名患者。大多数患者(66.7%)表现为孤立的甲状舌管囊肿。只有4例患者术前细胞学怀疑为癌症(敏感性:33.3%)。在出现时,所有患者都是甲状腺功能正常的。在诊断为恶性肿瘤后,除2例甲状腺舌管囊肿癌小于10mm外,所有患者都进行了甲状腺全切除术。在接受甲状腺全切除术的10名患者中,7名(70%)患者被证实患有甲状腺癌,3名患者的甲状腺沉积物小于10毫米。甲状腺癌症沉积物的平均尺寸为7.2毫米(1-20毫米)。平均随访时间为44个月(5-120),所有患者在研究期结束时均存活且无复发。结论甲状腺舌管囊肿癌是一种罕见的疾病,其治疗应在多学科会议上讨论。与起源于甲状腺的分化型甲状腺癌症一样,它具有非凡的生存率。因此,这些癌症的治疗已转向更保守的方法,尽管必须考虑其特殊性:易发生囊外侵袭和可能的不同淋巴结侵袭。
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引用次数: 0
Manifestaciones otorrinolaringológicas en la viruela del mono 猴痘的耳鼻喉科表现
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-07-01 DOI: 10.1016/j.otorri.2022.10.002
Berta Alegre , Sara Jubés , Natalia Arango , Daniela Pastene , Eduardo Lehrer , Isabel Vilaseca

Background and objective

In the current health emergency declared by the World Health Organization (WHO) for monkeypox, few data on the otorhinolaryngological (ENT) manifestations of the disease have been detailed. The purpose of this study is to describe the clinical features of the ENT manifestations in monkeypox.

Material and methods

Descriptive analysis of 11 consecutive patients with odynodysphagia or oral cavity lesions referred to the ENT emergency department of a tertiary hospital with epidemiological risk factors suggestive of monkeypox infection. Clinical, diagnostic, and treatment findings are described.

Results

90.9% of the patients had previous unsafe sexual contact. The predominant presenting features included fever over 38 °C with severe odynodysphagia. Physical examination showed ulcers and exudative lesions of variable presentation in the upper respiratory tract. Smear of the lesions confirmed polymerase chain reaction (PCR) positivity for monkeypox in all patients.

Conclusions

Monkeypox virus infection can occur in the ENT area with multiple manifestations that require a high degree of epidemiological suspicion and confirmation with PCR to reach a diagnosis of certainty.

背景与目的在目前世界卫生组织(世界卫生组织)宣布的猴痘突发卫生事件中,关于该病耳鼻喉科(ENT)表现的资料很少。本研究的目的是描述猴痘耳鼻喉科表现的临床特征。材料和方法连续11例转诊至三级医院耳鼻喉科急诊的吞咽困难或口腔病变患者的描述性分析,这些患者的流行病学危险因素提示猴痘感染。介绍了临床、诊断和治疗结果。结果90.9%的患者有过不安全性接触史。主要表现为发烧超过38°C,伴有严重的吞咽困难。体格检查显示上呼吸道有溃疡和渗出性病变,表现各异。病灶涂片证实所有患者的猴痘聚合酶链式反应阳性。结论猴痘病毒感染可发生在耳鼻喉科,有多种表现,需要高度的流行病学怀疑和PCR确认才能确定诊断。
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引用次数: 0
High-resolution computerized tomography for ossicular replacement prostheses 听骨置换假体的高分辨率计算机断层扫描
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-07-01 DOI: 10.1016/j.otorri.2022.07.006
Pongsathorn Sagonrat , Kan Radeesri , Sirinan Junthong

Introduction

To study the accuracy of high-resolution computed tomography (HRCT) for assessing the ossicular structures in cadaveric temporal bone by the distance between temporal bone elements is of great interest.

Objectives

To record the distances between the malleal neck and both the stapedial head and footplate by HRCT. Further, after partially opening the temporal bone toward the ossicular structure, to record the actual distances between those structures during surgical dissection.

Material and methods

This study compared actual and HRCT measurements of cadaveric temporal bone. We studied, measured, and recorded distances within and between various structural elements. All data are reported as means and were analyzed to prove the accuracy of HRCT to assess ossicular structure from the temporal bone.

Results

This study included the temporal bones of 10 male and 10 female cadavers (mean age, 70.4 years). By surgical dissection, the distances between the malleal neck and the stapedial head and footplate were 3.40 and 5.30 mm, respectively (measured from the bone); by HRCT, the corresponding values were 3.35 and 5.29 mm. The intraclass correlation coefficients for assessing ossicular structure in contrast to the actual measurements were 0.901 (malleal neck to stapedial head) and 0.923 (malleal neck to stapedial footplate) (p < 0.05). There were no differences between the actual malleal neck to stapedial head (p = 0.793) or footplate (p = 0.242) measurements.

Conclusion

HRCT produced statistically comparable, reliable, and accurate measurements compared with actual measurements in cadaveric temporal bone.

引言研究高分辨率计算机断层扫描(HRCT)通过颞骨元件之间的距离来评估尸体颞骨中听骨结构的准确性具有重要意义。目的用HRCT记录踝颈与镫骨头及足板的距离。此外,在朝向听骨结构部分打开颞骨之后,在外科解剖期间记录这些结构之间的实际距离。材料和方法本研究比较了尸体颞骨的实际测量值和HRCT测量值。我们研究、测量并记录了各种结构元素内部和之间的距离。所有数据均作为平均值报告,并进行分析以证明HRCT评估颞骨听骨结构的准确性。结果本研究包括10具男性和10具女性(平均年龄70.4岁)的颞骨。通过手术解剖,踝颈与镫骨头和脚板之间的距离分别为3.40和5.30 mm(从骨骼测量);HRCT分别为3.35和5.29mm。与实际测量值相比,评估听骨结构的组内相关系数分别为0.901(踝颈至镫骨头)和0.923(踝颈到镫骨压板)(p<0.05)。实际踝颈至stapedia头(p=0.793)或压板(p=0.242)测量值之间无差异。结论HRCT测量结果与尸体颞骨的实际测量结果具有统计学可比性、可靠性和准确性。
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引用次数: 0
Melanoma maligno metastásico de laringe 喉转移性恶性黑色素瘤
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-05-01 DOI: 10.1016/j.otorri.2022.04.007
Daniel-Iván Martín-Jiménez, José Palacios-García, Serafín Sánchez-Gómez
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引用次数: 0
Evaluación acústica de la voz: la relevancia del ruido de fondo 声音的声学评估:背景噪音的相关性
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-05-01 DOI: 10.1016/j.otorri.2022.09.004
María-José Marsano-Cornejo , Ángel Roco-Videla
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引用次数: 0
Unidad de Atención al Paciente Traqueostomizado. Una solución innovadora desde Otorrinolaringología con carácter transversal para el hospital 气管造口患者护理单位。从耳鼻喉到医院的横向创新解决方案
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-05-01 DOI: 10.1016/j.otorri.2022.04.005
Serafín Sánchez-Gómez , Beatriz Tena-García , Daniel Iván Martín Jiménez , Marta Álvarez Cendrero , Santiago Cuello Entrena , Nuria López González , Julissa Vizcarra Melgar , Elena Molina-Fernández , Rocío Tabernero Gallego , Juan Lorente Guerrero , José María Palacios-García

Background and objective

The care of tracheostomized patients are high risk skills and low incidence. Strategies for improvement of health care in hospital wards and specialties other than otolaryngology based solely on training have not been able to offer an adequate solution. A tracheostomized patient unit is presented directed by the otolaryngology service to attend all tracheostomized hospitalized patients of all specialties.

Material and methods

Background: Third level public hospital with 876 hospitalization beds and 30 ICU beds for 481,296 inhabitants. Unit model: Transversal unit for the hospital providing attention to all tracheostomized patients, adults, and children, of all specialties, with dedication of 50% of a ENT nurse of hospitalization that moves to the hospitalization bed of the specialty of each patient and 50% of another office ENT nurse for ambulatory patients care, with the consultancy of an ENT specialist and coordinated by the ENT supervisor.

Results

572 patients between 2016 and 2021, 80% men, aged 63 ± 14 years, were attended in the unit. 14.7 ± 2 tracheostomized patients daily and 96 ± 4 complication annual consultations were attended, rising up to 19 tracheostomized patients daily by 2020 and 141 ± 8.4 consultations by complications in 2020 and 2021, during the COVID-19 pandemic. The mean stay of the non-ENT specialties was reduced in 13 days, increasing the satisfaction of the ENT and non-ENT professionals and the satisfaction of the users.

Conclusions

A Tracheostomized Patient Care Unit proactively directed from the Otorhinolaryngology Service to transversally care for all tracheostomized patients improves the quality of health care by reducing stay, complications, and emergencies. Improves the satisfaction of non-otolaryngological professionals by reducing the anxiety of facing care of patients who lack knowledge and experience and that of ENT specialists and nurses by reducing unplanned extemporaneous demands for care. Improves user satisfaction by perceiving adequate continuity of care. The Otorhinolaryngology Services provide their experience in the management of laryngectomized and tracheostomized patients and in teamwork with other specialists and professionals without the need to create new structures outside otorhinolaryngology.

背景与目的气管造口术患者的护理是高危技能和低发生率。仅以培训为基础的改善医院病房和耳鼻喉科以外专科保健的战略未能提供适当的解决办法。气管造口病人单位是由耳鼻喉科指导,以出席所有气管造口住院病人的所有专科。资料与方法背景:公立三级医院,住院床位876张,重症监护床位30张,居民481296人。单元模式:医院的横向单元,为所有气管造口患者提供护理,包括成人和儿童,所有专科,50%的住院耳鼻喉科护士奉献到每个患者专科的住院床位,50%的另一名办公室耳鼻喉科护士奉献到门诊患者护理,在耳鼻喉科专家的咨询下,由耳鼻喉科主管协调。结果2016 - 2021年共收治572例患者,其中80%为男性,年龄63±14岁。在2019冠状病毒病大流行期间,每天有14.7±2例气管造瘘患者,每年有96±4例并发症问诊,到2020年每天有19例气管造瘘患者,2020年和2021年每年有141±8.4例并发症问诊。非耳鼻喉科的平均住院时间缩短了13天,提高了耳鼻喉科和非耳鼻喉科专业人员的满意度和使用者的满意度。结论由耳鼻喉科主动指导气管造口病人护理室对所有气管造口病人进行横向护理,减少住院时间、并发症和紧急情况,提高了医疗质量。通过减少缺乏知识和经验的患者面对护理的焦虑,以及通过减少计划外的临时护理需求,提高非耳鼻喉科专业人员的满意度。通过感知护理的适当连续性来提高用户满意度。耳鼻喉科服务提供他们在喉切除术和气管造口术患者管理方面的经验,并与其他专家和专业人员合作,而无需在耳鼻喉科之外创建新的结构。
{"title":"Unidad de Atención al Paciente Traqueostomizado. Una solución innovadora desde Otorrinolaringología con carácter transversal para el hospital","authors":"Serafín Sánchez-Gómez ,&nbsp;Beatriz Tena-García ,&nbsp;Daniel Iván Martín Jiménez ,&nbsp;Marta Álvarez Cendrero ,&nbsp;Santiago Cuello Entrena ,&nbsp;Nuria López González ,&nbsp;Julissa Vizcarra Melgar ,&nbsp;Elena Molina-Fernández ,&nbsp;Rocío Tabernero Gallego ,&nbsp;Juan Lorente Guerrero ,&nbsp;José María Palacios-García","doi":"10.1016/j.otorri.2022.04.005","DOIUrl":"10.1016/j.otorri.2022.04.005","url":null,"abstract":"<div><h3>Background and objective</h3><p>The care of tracheostomized patients are high risk skills and low incidence. Strategies for improvement of health care in hospital wards and specialties other than otolaryngology based solely on training have not been able to offer an adequate solution. A tracheostomized patient unit is presented directed by the otolaryngology service to attend all tracheostomized hospitalized patients of all specialties.</p></div><div><h3>Material and methods</h3><p>Background: Third level public hospital with 876 hospitalization beds and 30 ICU beds for 481,296 inhabitants. <em>Unit model</em>: Transversal unit for the hospital providing attention to all tracheostomized patients, adults, and children, of all specialties, with dedication of 50% of a ENT nurse of hospitalization that moves to the hospitalization bed of the specialty of each patient and 50% of another office ENT nurse for ambulatory patients care, with the consultancy of an ENT specialist and coordinated by the ENT supervisor.</p></div><div><h3>Results</h3><p>572 patients between 2016 and 2021, 80% men, aged 63<!--> <!-->±<!--> <!-->14 years, were attended in the unit. 14.7<!--> <!-->±<!--> <!-->2 tracheostomized patients daily and 96<!--> <!-->±<!--> <!-->4 complication annual consultations were attended, rising up to 19 tracheostomized patients daily by 2020 and 141<!--> <!-->±<!--> <!-->8.4 consultations by complications in 2020 and 2021, during the COVID-19 pandemic. The mean stay of the non-ENT specialties was reduced in 13 days, increasing the satisfaction of the ENT and non-ENT professionals and the satisfaction of the users.</p></div><div><h3>Conclusions</h3><p>A Tracheostomized Patient Care Unit proactively directed from the Otorhinolaryngology Service to transversally care for all tracheostomized patients improves the quality of health care by reducing stay, complications, and emergencies. Improves the satisfaction of non-otolaryngological professionals by reducing the anxiety of facing care of patients who lack knowledge and experience and that of ENT specialists and nurses by reducing unplanned extemporaneous demands for care. Improves user satisfaction by perceiving adequate continuity of care. The Otorhinolaryngology Services provide their experience in the management of laryngectomized and tracheostomized patients and in teamwork with other specialists and professionals without the need to create new structures outside otorhinolaryngology.</p></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"74 3","pages":"Pages 148-159"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47721781","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: 1
Value of simple otoscopy in diagnosing otitis media with effusion in children 单纯耳镜对儿童积液性中耳炎的诊断价值
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-05-01 DOI: 10.1016/j.otorri.2022.07.002
Cátia Azevedo , João Firmino Machado , António Fontes Lima , Fernando Milhazes Mar , Sérgio Vilarinho , Luís Dias

Aims

To explore the value of otoscopy in diagnosing OME when performed by otorhinolaryngology, pediatrics, and primary care physicians; to evaluate the interobserver and intraobserver agreement of interpretation of otoscopy images.

Material and methods

A cross-sectional study using an anonymous mailed survey was used. We presented pre-recorded otoscopy images of pediatric patients to otorhinolaryngology, pediatrics, and primary care physicians (ten volunteer specialists and residents from each medical specialty). All participants had to answer “yes” or “no” if they considered that the image corresponded or not to an OME case, respectively. We considered that the images were positive for OME whenever the respective tympanogram was type B.

Results

Thirty-one otoscopy images and 1860 responses provided by sixty physicians were analyzed. The accuracy of otoscopy in diagnosing OME was highest in the Otolaryngologists group (mean 74.8%), with the worst rate observed in the primary care residents group (mean 51.3%). Overall sensitivity, specificity, and positive predictive value of otoscopy for diagnosing OME were significantly higher when performed by otorhinolaryngologists (75.8%, 72.8%, 66.8%, respectively). Fleiss' kappa showed that interobserver agreement was globally weak within each group of specialties, with overall better interobserver agreement observed among otorhinolaryngologists (κ = 0.30; 95% CI 0.27–0.32).

Conclusion

According to our data, simple otoscopy as a single diagnostic method in pediatric OME is insufficient, even for otorhinolaryngologists. Current recommendations must be followed to improve diagnostic accuracy.

目的探讨耳鼻喉科、儿科和初级保健医生进行耳镜检查诊断OME的价值;评估观察者之间和观察者内部对耳镜图像解释的一致性。材料和方法采用匿名邮寄调查的横断面研究。我们向耳鼻喉科、儿科和初级保健医生(每个医学专业的十名志愿者专家和住院医生)提供了预先记录的儿科患者的耳镜图像。如果所有参与者认为图像对应或不对应OME病例,他们必须分别回答“是”或“否”。我们认为,只要相应的鼓室图为B型,这些图像都是OME阳性的。结果分析了60名医生提供的31张耳镜图像和1860份响应。耳鼻喉科医生组的耳镜检查诊断OME的准确率最高(平均74.8%),而初级保健住院医师组的准确率最差(平均51.3%)。耳鼻咽喉科医生进行耳镜检查对诊断OME总体敏感性、特异性和阳性预测值显著更高(分别为75.8%、72.8%和66.8%)。Fleiss’kappa显示,在每组专业中,观察者之间的一致性总体较弱,耳鼻喉科医生观察到的观察者之间一致性总体较好(κ = 0.30;95%可信区间0.27–0.32)。结论根据我们的数据,即使对耳鼻喉科医生来说,简单的耳镜检查作为儿童OME的单一诊断方法也是不够的。必须遵循当前的建议以提高诊断准确性。
{"title":"Value of simple otoscopy in diagnosing otitis media with effusion in children","authors":"Cátia Azevedo ,&nbsp;João Firmino Machado ,&nbsp;António Fontes Lima ,&nbsp;Fernando Milhazes Mar ,&nbsp;Sérgio Vilarinho ,&nbsp;Luís Dias","doi":"10.1016/j.otorri.2022.07.002","DOIUrl":"https://doi.org/10.1016/j.otorri.2022.07.002","url":null,"abstract":"<div><h3>Aims</h3><p><span>To explore the value of otoscopy<span> in diagnosing OME when performed by otorhinolaryngology, pediatrics, and </span></span>primary care physicians; to evaluate the interobserver and intraobserver agreement of interpretation of otoscopy images.</p></div><div><h3>Material and methods</h3><p>A cross-sectional study using an anonymous mailed survey was used. We presented pre-recorded otoscopy images of pediatric patients to otorhinolaryngology, pediatrics, and primary care physicians (ten volunteer specialists and residents from each medical specialty). All participants had to answer “yes” or “no” if they considered that the image corresponded or not to an OME case, respectively. We considered that the images were positive for OME whenever the respective tympanogram was type B.</p></div><div><h3>Results</h3><p>Thirty-one otoscopy images and 1860 responses provided by sixty physicians were analyzed. The accuracy of otoscopy in diagnosing OME was highest in the Otolaryngologists group (mean 74.8%), with the worst rate observed in the primary care residents group (mean 51.3%). Overall sensitivity, specificity, and positive predictive value of otoscopy for diagnosing OME were significantly higher when performed by otorhinolaryngologists (75.8%, 72.8%, 66.8%, respectively). Fleiss' kappa showed that interobserver agreement was globally weak within each group of specialties, with overall better interobserver agreement observed among otorhinolaryngologists (κ = 0.30; 95% CI 0.27–0.32).</p></div><div><h3>Conclusion</h3><p>According to our data, simple otoscopy as a single diagnostic method in pediatric OME is insufficient, even for otorhinolaryngologists. Current recommendations must be followed to improve diagnostic accuracy.</p></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"74 3","pages":"Pages 175-181"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778568","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
Impact of adenotonsillectomy in pediatric respiratory function 腺扁桃体切除术对儿童呼吸功能的影响
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-05-01 DOI: 10.1016/j.otorri.2022.09.001
Francisco Alves de Sousa , Sara Raquel Azevedo , Ana Nóbrega Pinto, Miguel Bebiano Coutinho, Luís Meireles, Cecília Almeida e Sousa

Introduction

Adenotonsillar hypertrophy (ATH) is an important health condition that leads to upper airway obstruction and constitutes the main cause of obstructive sleep disordered breathing (OSDB) in children. The aim of this study was to analyze the effect of surgical intervention on spirometrical parameters of children with ATH/OSDB and upper airway recurrent infections (URTIs).

Material and methods

The study covered children treated surgically in a Pediatric Ambulatory Unit in a tertiary hospital. Spirometric tests were performed before and three months after surgery and results were compared.

Results

A total of 78 children were enrolled with a mean age of 6.95 ± 2,81 years. There was a significant improvement in forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow (PEF) and forced expiratory flow rate at 25% (F25) values after surgery in children suffering from OSDB (FVC pre: 1.52 ± 0.47 L vs FVC post: 1.85 ± 0.63 L, p < 0.001; FEV1 pre: 1.24 ± 0.38 L vs FEV1 post: 1.39 ± 0.40 L, p = 0.014; PEF pre: 2.04 ± 0.85 L/s vs PEF post: 2.33 ± 0.76 L/s, p = 0.014; F25 pre: 1.77 ± 0.77 L/s vs F25 post: 2.02 ± 0.73 L/s, p = 0.030). On a multivariate analysis model, preoperative tonsil size and performing tonsillectomy were the most significant determinants of improvement in spirometric values (p < 0.05). Children with isolated adenoid hypertrophy without tonsillar obstruction and those with URTIs alone did not show relevant differences in spirometric values after surgery (p > 0.05). No significant differences were found concerning pre-operative and post-operative forced expiratory flow rate at 75% (F75) and forced expiratory flow between 25 and 75% of the pulmonary volume (FEF25–75%) in any group (p > 0.05).

Conclusions

Surgery seems effective in ameliorating spirometry values in patients with OSDB and ATH, namely FVC, FEV1, PEF and F25. Spirometry may give a clue on the importance of adequate surgical resolution of pediatric lymphoid hypertrophy obstruction. No significant differences exist on spirometric parameters of children with isolated adenoid hypertrophy and URTIs without ATH. Further studies are needed in order to evaluate the potential benefit of spirometry utilization in the daily clinical setting.

腺扁桃体肥大(ATH)是导致上呼吸道阻塞的一种重要健康状况,也是儿童阻塞性睡眠呼吸障碍(OSDB)的主要原因。本研究的目的是分析手术干预对ATH/OSDB和上呼吸道复发性感染(URTI)儿童肺活量参数的影响。材料和方法该研究涵盖了在三级医院儿科门诊部接受手术治疗的儿童。在手术前和手术后三个月进行了螺旋测量测试,并对结果进行了比较。结果共有78名儿童入学,平均年龄6.95岁 ± 2.81岁。患有OSDB的儿童术后用力肺活量(FVC)、第一秒用力呼气量(FEV1)、呼气峰流量(PEF)和25%用力呼气流速(F25)值均有显著改善(FVC pre:1.52 ± 0.47 L与FVC后:1.85 ± 0.63 L、 p <; 0.001;FEV1预版本:1.24 ± 0.38 L vs FEV1后:1.39 ± 0.40 L、 p = 0.014;PEF前:2.04 ± 0.85 L/s与PEF后:2.33 ± 0.76 L/s,p = 0.014;F25预版本:1.77 ± 0.77 L/s vs F25后:2.02 ± 0.73 L/s,p = 0.030)。在多变量分析模型中,术前扁桃体大小和进行扁桃体切除术是肺活量测定值改善的最显著决定因素(p <; 无扁桃体阻塞的孤立性腺样体肥大患儿与单纯URTI患儿术后肺活量测定值无相关差异(p >; 术前和术后用力呼气流速为75%(F75),用力呼气流速在肺容量的25%和75%之间(FEF25-75%),在任何一组中均未发现显著差异(p >; 结论外科手术可有效改善OSDB和ATH患者的肺活量测定值,即FVC、FEV1、PEF和F25。肺活量测定法可能为儿童淋巴肥大梗阻的充分手术解决的重要性提供线索。孤立性腺样体肥大儿童和无ATH的URTI儿童的肺活量测定参数没有显著差异。需要进一步的研究来评估肺活量测定法在日常临床环境中的潜在益处。
{"title":"Impact of adenotonsillectomy in pediatric respiratory function","authors":"Francisco Alves de Sousa ,&nbsp;Sara Raquel Azevedo ,&nbsp;Ana Nóbrega Pinto,&nbsp;Miguel Bebiano Coutinho,&nbsp;Luís Meireles,&nbsp;Cecília Almeida e Sousa","doi":"10.1016/j.otorri.2022.09.001","DOIUrl":"https://doi.org/10.1016/j.otorri.2022.09.001","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Adenotonsillar hypertrophy<span> (ATH) is an important health condition that leads to upper airway obstruction and constitutes the main cause of </span></span>obstructive sleep disordered breathing<span> (OSDB) in children. The aim of this study was to analyze the effect of surgical intervention on spirometrical parameters of children with ATH/OSDB and upper airway recurrent infections (URTIs).</span></p></div><div><h3>Material and methods</h3><p>The study covered children treated surgically in a Pediatric Ambulatory Unit in a tertiary hospital. Spirometric tests were performed before and three months after surgery and results were compared.</p></div><div><h3>Results</h3><p><span>A total of 78 children were enrolled with a mean age of 6.95 ± 2,81 years. There was a significant improvement in forced vital capacity<span> (FVC), forced expiratory volume<span><span><span> in the first second (FEV1), peak expiratory flow (PEF) and </span>forced expiratory flow rate at 25% (F25) values after surgery in children suffering from OSDB (FVC pre: 1.52 ± 0.47 L vs FVC post: 1.85 ± 0.63 L, p &lt; 0.001; FEV1 pre: 1.24 ± 0.38 L vs FEV1 post: 1.39 ± 0.40 L, p = 0.014; PEF pre: 2.04 ± 0.85 L/s vs PEF post: 2.33 ± 0.76 L/s, p = 0.014; F25 pre: 1.77 ± 0.77 L/s vs F25 post: 2.02 ± 0.73 L/s, p = 0.030). On a </span>multivariate analysis<span><span> model, preoperative tonsil size and performing </span>tonsillectomy<span> were the most significant determinants of improvement in spirometric values (p &lt; 0.05). Children with isolated adenoid hypertrophy without tonsillar obstruction and those with URTIs alone did not show relevant differences in spirometric values after surgery (p &gt; 0.05). No significant differences were found concerning pre-operative and post-operative forced expiratory flow rate at 75% (F75) and forced expiratory flow between 25 and 75% of the pulmonary volume (FEF</span></span></span></span></span><sub>25–75%</sub>) in any group (p &gt; 0.05).</p></div><div><h3>Conclusions</h3><p>Surgery seems effective in ameliorating spirometry<span> values in patients with OSDB and ATH, namely FVC, FEV1, PEF and F25. Spirometry may give a clue on the importance of adequate surgical resolution of pediatric lymphoid hypertrophy obstruction. No significant differences exist on spirometric parameters of children with isolated adenoid hypertrophy and URTIs without ATH. Further studies are needed in order to evaluate the potential benefit of spirometry utilization in the daily clinical setting.</span></p></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"74 3","pages":"Pages 182-191"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778572","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
Resultados de la radioterapia en los carcinomas de orofaringe 口咽癌的放射治疗结果
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2023-05-01 DOI: 10.1016/j.otorri.2022.04.002
Xavier León , Núria Farré , Laura Montezuma , Anna Holgado , Rosselin Vásquez , Eduard Neumann , Miquel Quer

Objective

To present the results of radiotherapy treatment in patients with oropharyngeal carcinomas.

Material and methods

Retrospective study of a cohort of 359 patients treated with radiotherapy, including chemo- and bio-radiotherapy, during the period 2000-2019. Information on human papillomavirus (HPV) status was available for 202 patients, of whom 26.2% were HPV-positive.

Results

Five-year local recurrence-free survival was 73.5% (95% CI: 68.8-78.2%). The variables that were related to local disease control in a multivariate study were the local tumor extension category and the HPV status. Five-year local recurrence-free survival for patients with cT1 tumors was 90.0%, for cT2 88.0%, for cT3 70.6%, and for cT4 42.3%. Five-year local recurrence-free survival for HPV-negative tumors was 67.2% and for HPV-positive tumors 93.3%. Five-year specific-disease survival was 64.4% (95% CI: 59.1-69.7%). Variables that were related to specific survival in a multivariate study were the patient's general condition, local and regional extent of the tumor, and HPV status.

Conclusions

Five-year local recurrence-free survival of patients with oropharyngeal carcinomas treated with radiotherapy was 73.5%. Variables that were related to local control were local tumor extension and HPV status.

目的介绍放射治疗口咽癌的疗效。材料和方法2000-2019年期间359名接受放疗(包括化疗和生物放疗)的患者队列的回顾性研究。202名患者的人乳头瘤病毒(HPV)状态信息可用,其中26.2%为HPV阳性。结果五年局部无复发生存率为73.5%(95%CI:68.8-78.2%)。在一项多变量研究中,与局部疾病控制相关的变量是局部肿瘤扩展类别和HPV状态。cT1肿瘤患者的5年局部无复发生存率为90.0%、cT2为88.0%、cT3为70.6%,cT4为42.3%。HPV阴性肿瘤的五年局部无复发生存率为67.2%,HPV阳性肿瘤为93.3%。五年特异性疾病生存率为64.4%(95%可信区间:59.1-69.7%)。在一项多变量研究中,与特异性生存率相关的变量是患者的总体状况、肿瘤的局部和区域范围以及HPV状态。结论口咽癌放疗后5年局部无复发生存率为73.5%,与局部控制相关的变量为局部肿瘤扩展和HPV状态。
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Acta otorrinolaringologica espanola
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