Pub Date : 2025-09-01DOI: 10.1016/j.otorri.2025.512264
Anna Penella , Alejandro Portillo , Ricardo Bartel , Jose María Caballero , Enric Cisa , Francesc Cruellas , Mireia Golet , Jose L Sanmillan , Alberto Torres , Xavier González-Compta
Objective
To identify predictive factors for ear-nose-throat (ENT) complications in patients undergoing skull base surgery via extended endoscopic endonasal approaches (EEEA).
Methods
Single-center retrospective observational study of a cohort of patients who underwent EEEA for skull base surgery between January 2015 and December 2021. Patients were stratified according to ENT complications.
Results
Sixty-one patients were included in the study: 37 women (60.66%) and 24 men (39.34%). Craniopharyngioma was the most frequently observed pathology (36%). 40 patients (65,57%) presented with ENT complications, being olfactory disturbance the most common complication (40,98%), followed by nasal obstruction (24,59%) and synechiae formation (18,03%). Logistic regression analysis revealed that younger age (P = .026) and excision of middle turbinates during EEEA surgery (P = .034) were independent factors with a significant association with ENT complications. Anterior septal deviation was an independent factor significantly associated with synechiae formation (P = .023).
Conclusion
Surgeons performing skull base surgery using EEEA should be aware that excision of middle turbinate, younger age and anterior septal deviation may be risk factors for ENT postoperative complications.
{"title":"Skull base surgery via extended endoscopic endonasal approach: Predictors of ear-nose-throat complications","authors":"Anna Penella , Alejandro Portillo , Ricardo Bartel , Jose María Caballero , Enric Cisa , Francesc Cruellas , Mireia Golet , Jose L Sanmillan , Alberto Torres , Xavier González-Compta","doi":"10.1016/j.otorri.2025.512264","DOIUrl":"10.1016/j.otorri.2025.512264","url":null,"abstract":"<div><h3>Objective</h3><div>To identify predictive factors for ear-nose-throat (ENT) complications in patients undergoing skull base surgery via extended endoscopic endonasal approaches (EEEA).</div></div><div><h3>Methods</h3><div>Single-center retrospective observational study of a cohort of patients who underwent EEEA for skull base surgery between January 2015 and December 2021. Patients were stratified according to ENT complications.</div></div><div><h3>Results</h3><div>Sixty-one patients were included in the study: 37 women (60.66%) and 24 men (39.34%). Craniopharyngioma was the most frequently observed pathology (36%). 40 patients (65,57%) presented with ENT complications, being olfactory disturbance the most common complication (40,98%), followed by nasal obstruction (24,59%) and synechiae formation (18,03%). Logistic regression analysis revealed that younger age (<em>P</em> = .026) and excision of middle turbinates during EEEA surgery (<em>P</em> = .034) were independent factors with a significant association with ENT complications. Anterior septal deviation was an independent factor significantly associated with synechiae formation (<em>P</em> = .023).</div></div><div><h3>Conclusion</h3><div>Surgeons performing skull base surgery using EEEA should be aware that excision of middle turbinate, younger age and anterior septal deviation may be risk factors for ENT postoperative complications.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512264"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108268","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}
Pub Date : 2025-09-01DOI: 10.1016/j.otorri.2025.512261
Sahil Kakar , Keshav Kumar Gupta , Emma Richards , Colin Shirley , Paige Bradley , Anita Sonsale
Purpose
Spasmodic dysphonia (SD) is a debilitating disorder primarily affecting voice production. Current treatment includes repeat botulinum toxin (botox) injections for symptomatic management. The aim of this study is to review the impact of botox injections on patient reported outcome measures (PROM), using a novel and unique quality of life, proforma, and side effects in patients treated at our centre.
Methods
This retrospective case series evaluated all patients who were treated in our specialised voice clinic, at a single tertiary referral centre between May 2019 and April 2024 with botox for SD. The primary outcome measure was PROM of voice quality weekly post-injection as per a unique proforma. Variables extracted included patient demographics, treatment specifics and complications.
Results
Fifty-two patients were included representing 21 (40.4%) males. Forty-two (80.8%) suffered from adductor spasmodic dysphonia with 8 (15.4%) having abductor dysphonia and 1 (1.92%) with mixed dysphonia. Patients with abductor dysphonia had a statistical improvement in voice following dose 2, (1.8–3.0, p = 0.03) and dose 3 (1.4–3.2, p = <0.001). Patients with adductor dysphonia had significant improvements in voice following all doses (2.1–2.9, p = 0.01), (1.9–3.0, p = <0.01) and (2.1–3.0, p = <0.01). The most common complication was a ‘breathy voice’, ranging from 31.4% to 51.0% but all patients reported this as transient.
Conclusion
Patient reported quality of voice is improved following botox injections for spasmodic dysphonia, and most patients do not suffer from long-term complications.
{"title":"Patient reported voice outcomes following multi-disciplinary approach to botulism toxin for spasmodic dysphonia","authors":"Sahil Kakar , Keshav Kumar Gupta , Emma Richards , Colin Shirley , Paige Bradley , Anita Sonsale","doi":"10.1016/j.otorri.2025.512261","DOIUrl":"10.1016/j.otorri.2025.512261","url":null,"abstract":"<div><h3>Purpose</h3><div>Spasmodic dysphonia (SD) is a debilitating disorder primarily affecting voice production. Current treatment includes repeat botulinum toxin (botox) injections for symptomatic management. The aim of this study is to review the impact of botox injections on patient reported outcome measures (PROM), using a novel and unique quality of life, proforma, and side effects in patients treated at our centre.</div></div><div><h3>Methods</h3><div>This retrospective case series evaluated all patients who were treated in our specialised voice clinic, at a single tertiary referral centre between May 2019 and April 2024 with botox for SD. The primary outcome measure was PROM of voice quality weekly post-injection as per a unique proforma. Variables extracted included patient demographics, treatment specifics and complications.</div></div><div><h3>Results</h3><div>Fifty-two patients were included representing 21 (40.4%) males. Forty-two (80.8%) suffered from adductor spasmodic dysphonia with 8 (15.4%) having abductor dysphonia and 1 (1.92%) with mixed dysphonia. Patients with abductor dysphonia had a statistical improvement in voice following dose 2, (1.8–3.0, <em>p</em> <!-->=<!--> <!-->0.03) and dose 3 (1.4–3.2, <em>p</em> = <0.001). Patients with adductor dysphonia had significant improvements in voice following all doses (2.1–2.9, <em>p</em> <!-->=<!--> <!-->0.01), (1.9–3.0, <em>p</em> = <0.01) and (2.1–3.0, <em>p</em> = <0.01). The most common complication was a ‘breathy voice’, ranging from 31.4% to 51.0% but all patients reported this as transient.</div></div><div><h3>Conclusion</h3><div>Patient reported quality of voice is improved following botox injections for spasmodic dysphonia, and most patients do not suffer from long-term complications.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512261"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108263","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}
{"title":"Disease control in unresectable laryngeal carcinoma cuniculatum using pembrolizumab and chemotherapy: A case report","authors":"Natalia Arango Cabezas , Rosa Delia Ramirez-Ruiz , Nuria Cuesta , Isabel Vilaseca","doi":"10.1016/j.otorri.2025.512270","DOIUrl":"10.1016/j.otorri.2025.512270","url":null,"abstract":"","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512270"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108265","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}
Pub Date : 2025-09-01DOI: 10.1016/j.otorri.2025.512262
Monica Rueda Vega , M Montserrat Asensi Diaz , María C Scola Torres , Carolina López Granados , Mónica Hernando , Juan Antonio Pasamontes
Introduction
After the development of antibiotics and early diagnostic methods, the complications of acute rhinosinusitis (ARS) have reduced in recent years. However, in clinical practice, we still observe both orbital and intracranial complications.
The aim of this study is to describe a series of patients with complications of ARS and to define what clinical and radiological characteristics may indicate the need of surgical treatment.
Materials
Retrospective observational study of patients diagnosed with orbital complications secondary to ARS who were hospitalized at a tertiary hospital between 2010 and 2023. Demographic, clinical, radiological, microbiological data, therapeutic strategy and hospitalization time were studied.
Results
Fifty-six patients were included (59% male), with a mean age of 11.5 years (37 under 18 years old). The most frequent symptoms were eyelid edema (98%) and erythema (89%), proptosis (46%) and fever (50%). According to Chandler’s classification, the most frequent complications were subperiosteal abscesses (46%) and orbital cellulitis (23%). There were six cases of orbital abscesses and one cavernous sinus thrombosis. The most frequently used antibiotic was amoxicillin + clavulanic acid (54%). Surgical intervention was necessary in 26 patients (46%).
Conclusion
Orbital complications of ARS are rare, but they can have potentially vision-threatening and life-threatening complications. Therefore, it is essential to consider them in the differential diagnosis, and in case of suspicion, initiate antibiotic treatment as soon as possible, with or without surgical drainage. Endoscopic surgery is the preferred approach, but it may be necessary to combine it with external drainage, especially in lateral locations or on the orbital roof.
{"title":"Management of orbital complications of acute rhinosinusitis: A 13-year experience","authors":"Monica Rueda Vega , M Montserrat Asensi Diaz , María C Scola Torres , Carolina López Granados , Mónica Hernando , Juan Antonio Pasamontes","doi":"10.1016/j.otorri.2025.512262","DOIUrl":"10.1016/j.otorri.2025.512262","url":null,"abstract":"<div><h3>Introduction</h3><div>After the development of antibiotics and early diagnostic methods, the complications of acute rhinosinusitis (ARS) have reduced in recent years. However, in clinical practice, we still observe both orbital and intracranial complications.</div><div>The aim of this study is to describe a series of patients with complications of ARS and to define what clinical and radiological characteristics may indicate the need of surgical treatment.</div></div><div><h3>Materials</h3><div>Retrospective observational study of patients diagnosed with orbital complications secondary to ARS who were hospitalized at a tertiary hospital between 2010 and 2023. Demographic, clinical, radiological, microbiological data, therapeutic strategy and hospitalization time were studied.</div></div><div><h3>Results</h3><div>Fifty-six patients were included (59% male), with a mean age of 11.5 years (37 under 18 years old). The most frequent symptoms were eyelid edema (98%) and erythema (89%), proptosis (46%) and fever (50%). According to Chandler’s classification, the most frequent complications were subperiosteal abscesses (46%) and orbital cellulitis (23%). There were six cases of orbital abscesses and one cavernous sinus thrombosis. The most frequently used antibiotic was amoxicillin + clavulanic acid (54%). Surgical intervention was necessary in 26 patients (46%).</div></div><div><h3>Conclusion</h3><div>Orbital complications of ARS are rare, but they can have potentially vision-threatening and life-threatening complications. Therefore, it is essential to consider them in the differential diagnosis, and in case of suspicion, initiate antibiotic treatment as soon as possible, with or without surgical drainage. Endoscopic surgery is the preferred approach, but it may be necessary to combine it with external drainage, especially in lateral locations or on the orbital roof.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512262"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108266","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}
To determine the prevalence of variants in the DIAPH1 gene among patients with bilateral sensorineural hearing loss of unknown etiology in northern Spain and to characterize the associated phenotype. As a secondary objective, this study aims to improve genetic counseling by linking genotype to phenotype through clinical characterization of variant carriers.
Patients and methods
A six-year observational descriptive study was conducted at a tertiary referral center. Patients with bilateral sensorineural hearing loss of unknown origin were evaluated using DNA sequencing through next-generation sequencing. A gene panel was utilized to identify pathogenic or likely pathogenic variants in the DIAPH1 gene.
Results
Among 385 patients with SNHL, four (1%) harbored DIAPH1 variants. Two patients (0.5%) had pathogenic or likely pathogenic variants associated with macrothrombocytopenia and neutropenia (c.3586dupA, c.3575-3C > G), exhibiting early-onset, progressive bilateral SNHL, and vestibular abnormalities. One received a cochlear implant with good outcomes. Conclusions: Pathogenic variants in the DIAPH1 gene are rare among patients with bilateral sensorineural hearing loss of unknown etiology in northern Spain. These variants lead to bilateral SNHL with autosomal dominant inheritance. In our study, we identified two novel pathogenic DIAPH1 variants associated with macrothrombocytopenia, and also presenting neutropenia and vestibular involvement.
{"title":"Exploring DIAPH1 gene mutations in patients with sensorineural hearing loss of unknown etiology in Northern Spain","authors":"Rocío González-Aguado , Aida Veiga-Alonso , Esther Onecha-De La Fuente , Carmelo Morales-Angulo","doi":"10.1016/j.otorri.2025.512269","DOIUrl":"10.1016/j.otorri.2025.512269","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the prevalence of variants in the DIAPH1 gene among patients with bilateral sensorineural hearing loss of unknown etiology in northern Spain and to characterize the associated phenotype. As a secondary objective, this study aims to improve genetic counseling by linking genotype to phenotype through clinical characterization of variant carriers.</div></div><div><h3>Patients and methods</h3><div>A six-year observational descriptive study was conducted at a tertiary referral center. Patients with bilateral sensorineural hearing loss of unknown origin were evaluated using DNA sequencing through next-generation sequencing. A gene panel was utilized to identify pathogenic or likely pathogenic variants in the DIAPH1 gene.</div></div><div><h3>Results</h3><div>Among 385 patients with SNHL, four (1%) harbored DIAPH1 variants. Two patients (0.5%) had pathogenic or likely pathogenic variants associated with macrothrombocytopenia and neutropenia (c.3586dupA, c.3575-3C<!--> <!-->><!--> <!-->G), exhibiting early-onset, progressive bilateral SNHL, and vestibular abnormalities. One received a cochlear implant with good outcomes. Conclusions: Pathogenic variants in the DIAPH1 gene are rare among patients with bilateral sensorineural hearing loss of unknown etiology in northern Spain. These variants lead to bilateral SNHL with autosomal dominant inheritance. In our study, we identified two novel pathogenic DIAPH1 variants associated with macrothrombocytopenia, and also presenting neutropenia and vestibular involvement.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512269"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108261","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}
Pub Date : 2025-09-01DOI: 10.1016/j.otorri.2025.512263
Julia Fernández-Enseñat , Fabricio Benavides-Villanueva , Andrea Martínez-Camerano , Vanesa Calvo-Rio , Ricardo Blanco , Carmelo Morales-Angulo
Objectives
Eosinophilic granulomatosis with polyangiitis (EGPA) is an ANCA-associated vasculitis affecting multiple systems, with common ear, nose and throat (ENT) manifestations. This study aimed to evaluate the most frequent ENT manifestations in EGPA patients and the relationship between nasal polyps and other clinical findings such as ANCA tests and eosinophilia.
Materials and methods
A retrospective observational study was conducted on EGPA patients diagnosed between 2000 and 2024 at a tertiary hospital using the 2022 ACR/EULAR criteria. Head and neck examinations, including audiometry, and their imaging and histopathological studies were reviewed. Patients were classified based on the presence or absence of nasal polyps, and the relationship between ANCA positivity and eosinophilia was assessed.
Results
Of 173 patients with ANCA vasculitis, 22 met EGPA criteria, with a prevalence of 3.6 per 100,000 in Cantabria. Head and neck manifestations were observed in 90.5% of patients (19/21). Sinonasal involvement was the most frequent (82%), with otological manifestations in 31.8% (7/21). Nasal polyps were the most common manifestation (7/21). Head and neck biopsies were performed in 7 cases (32%), which showed no evidence of vasculitis. There was no statistically significant association between nasal polyps, ANCA positivity, and eosinophilia.
Conclusions
Sinonasal involvement is prevalent in EGPA, often presenting as chronic rhinitis or rhinosinusitis with or without polyps. Otological issues, such as eustachian tube dysfunction and sensorineural hearing loss, are also common. No laryngeal, oral, or salivary gland lesions were observed. There was no significant correlation between the presence of polyps and ANCA positivity or eosinophilia.
{"title":"Otorhinolaryngological manifestations in patients with eosinophilic granulomatosis with polyangiitis in a single university center","authors":"Julia Fernández-Enseñat , Fabricio Benavides-Villanueva , Andrea Martínez-Camerano , Vanesa Calvo-Rio , Ricardo Blanco , Carmelo Morales-Angulo","doi":"10.1016/j.otorri.2025.512263","DOIUrl":"10.1016/j.otorri.2025.512263","url":null,"abstract":"<div><h3>Objectives</h3><div>Eosinophilic granulomatosis with polyangiitis (EGPA) is an ANCA-associated vasculitis affecting multiple systems, with common ear, nose and throat (ENT) manifestations. This study aimed to evaluate the most frequent ENT manifestations in EGPA patients and the relationship between nasal polyps and other clinical findings such as ANCA tests and eosinophilia.</div></div><div><h3>Materials and methods</h3><div>A retrospective observational study was conducted on EGPA patients diagnosed between 2000 and 2024 at a tertiary hospital using the 2022 ACR/EULAR criteria. Head and neck examinations, including audiometry, and their imaging and histopathological studies were reviewed. Patients were classified based on the presence or absence of nasal polyps, and the relationship between ANCA positivity and eosinophilia was assessed.</div></div><div><h3>Results</h3><div>Of 173 patients with ANCA vasculitis, 22 met EGPA criteria, with a prevalence of 3.6 per 100,000 in Cantabria. Head and neck manifestations were observed in 90.5% of patients (19/21). Sinonasal involvement was the most frequent (82%), with otological manifestations in 31.8% (7/21). Nasal polyps were the most common manifestation (7/21). Head and neck biopsies were performed in 7 cases (32%), which showed no evidence of vasculitis. There was no statistically significant association between nasal polyps, ANCA positivity, and eosinophilia.</div></div><div><h3>Conclusions</h3><div>Sinonasal involvement is prevalent in EGPA, often presenting as chronic rhinitis or rhinosinusitis with or without polyps. Otological issues, such as eustachian tube dysfunction and sensorineural hearing loss, are also common. No laryngeal, oral, or salivary gland lesions were observed. There was no significant correlation between the presence of polyps and ANCA positivity or eosinophilia.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512263"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108267","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}
Pub Date : 2025-09-01DOI: 10.1016/j.otorri.2025.512267
Beatriz Pallarés Martí, Juan José Díaz Argüello, Yolanda Escamilla Carpintero
{"title":"Adenopatía retrofaríngea en carcinoma sobre divertículo de Zenker","authors":"Beatriz Pallarés Martí, Juan José Díaz Argüello, Yolanda Escamilla Carpintero","doi":"10.1016/j.otorri.2025.512267","DOIUrl":"10.1016/j.otorri.2025.512267","url":null,"abstract":"","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512267"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108269","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}
Pub Date : 2025-09-01DOI: 10.1016/j.otorri.2025.512266
María San Millán-González , Michael Bauer , Ana Fernández-Rodríguez , José Antonio Cámara-Arnaz
{"title":"Nódulos en bambú de las cuerdas vocales: un reto clínico poco común","authors":"María San Millán-González , Michael Bauer , Ana Fernández-Rodríguez , José Antonio Cámara-Arnaz","doi":"10.1016/j.otorri.2025.512266","DOIUrl":"10.1016/j.otorri.2025.512266","url":null,"abstract":"","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512266"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108264","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}
Pub Date : 2025-07-01DOI: 10.1016/j.otorri.2025.512235
Francisco Javier García-Callejo , Miguel Juantegui Azpilicueta , María Díaz Ferrer , Pablo Tiziano Guastella Almeida , John Deiver Cardona Henao
Introduction
Adequate nasal patency has been classically considered a crucial factor in middle ear ventilation. We valued the influence of nasosinusal polyposis on Eustachian tube function.
Material and methods
A prospective follow-up with all cases of chronic rhinosinusitis with nasal polyps assisted between January 2019 and October 2024 was carried out. Their endoscopic, radiological and clinical characteristics were noted, as well as the presence of a type 2 inflammation context and the incidence of middle ear pathology. Polypoid involvement and tubal dysfunction were studied using several scores: Lildholdt's scale, Lund-Mackay nasal polyp grading, Lund-Kennedy endoscopic scoring system, SNOT-22 and Eustachian Tube Dysfunction Questionnaire-7 score.
Results
Information was collected from 155 patients, with an incidence of 15.1 cases/100,000 inhabitants. A percentage of 70.9 showed a type 2 inflammation profile. This group showed a higher average of cases with acute otitis media and effusion (18.1 vs. 4.4%; p < 0.001), tympanometric alterations (12.7 vs. 4.4%; p < 0.01), conductive hearing loss (17.2 vs. 4.4%; p < 0.001) and needing for transtympanic drains (9.1 vs. 2.2%; p < 0.01) than the group without an eosinophilic profile or elevated IgE. The Eustachian Tube Dysfunction Questionnaire-7 score correlated well with the SNOT-22 and Lund-Kennedy scales.
Conclusions
Regression analysis revealed that a type 2 inflammation profile might play a more important role in tubal patency than nasal obstruction. Polyposis may alter Eustachian tube function, but more likely due to its inflammatory-allergic etiopathogenesis than to its obstructive nature.
适当的鼻通畅一直被认为是中耳通气的关键因素。我们评价鼻窦息肉病对咽鼓管功能的影响。材料与方法对2019年1月至2024年10月辅助治疗的所有慢性鼻窦炎伴鼻息肉患者进行前瞻性随访。他们的内窥镜、放射学和临床特征被记录下来，以及2型炎症背景和中耳病理的发生率。息肉累及和输卵管功能障碍采用几种评分方法进行研究：Lildholdt量表、Lund-Mackay鼻息肉分级、Lund-Kennedy内镜评分系统、SNOT-22和咽鼓管功能障碍问卷-7评分。结果共收集到155例患者资料，发病率为15.1例/10万居民。70.9%的人表现为2型炎症。该组急性中耳炎和积液的平均发生率较高(18.1 vs. 4.4%；p & lt;0.001)，鼓室改变(12.7 vs. 4.4%；p & lt;传导性听力损失(17.2 vs. 4.4%；p & lt;0.001)和需要经鼓室引流(9.1 vs. 2.2%；p & lt;0.01)高于无嗜酸性粒细胞或IgE升高组。咽鼓管功能障碍问卷-7评分与SNOT-22和Lund-Kennedy量表具有良好的相关性。结论回归分析显示，2型炎症对输卵管通畅的影响可能大于鼻塞。息肉病可能改变咽鼓管功能，但更可能是由于其炎症-过敏的发病机制，而不是其梗阻性。
{"title":"Impacto de la rinosinusitis crónica con pólipos nasales en la disfunción de la trompa de Eustaquio","authors":"Francisco Javier García-Callejo , Miguel Juantegui Azpilicueta , María Díaz Ferrer , Pablo Tiziano Guastella Almeida , John Deiver Cardona Henao","doi":"10.1016/j.otorri.2025.512235","DOIUrl":"10.1016/j.otorri.2025.512235","url":null,"abstract":"<div><h3>Introduction</h3><div>Adequate nasal patency has been classically considered a crucial factor in middle ear ventilation. We valued the influence of nasosinusal polyposis on Eustachian tube function.</div></div><div><h3>Material and methods</h3><div>A prospective follow-up with all cases of chronic rhinosinusitis with nasal polyps assisted between January 2019 and October 2024 was carried out. Their endoscopic, radiological and clinical characteristics were noted, as well as the presence of a type 2 inflammation context and the incidence of middle ear pathology. Polypoid involvement and tubal dysfunction were studied using several scores: Lildholdt's scale, Lund-Mackay nasal polyp grading, Lund-Kennedy endoscopic scoring system, SNOT-22 and Eustachian Tube Dysfunction Questionnaire-7 score.</div></div><div><h3>Results</h3><div>Information was collected from 155 patients, with an incidence of 15.1 cases/100,000 inhabitants. A percentage of 70.9 showed a type 2 inflammation profile. This group showed a higher average of cases with acute otitis media and effusion (18.1 vs. 4.4%; p<!--> <!--><<!--> <!-->0.001), tympanometric alterations (12.7 vs. 4.4%; p<!--> <!--><<!--> <!-->0.01), conductive hearing loss (17.2 vs. 4.4%; p<!--> <!--><<!--> <!-->0.001) and needing for transtympanic drains (9.1 vs. 2.2%; p<!--> <!--><<!--> <!-->0.01) than the group without an eosinophilic profile or elevated IgE. The Eustachian Tube Dysfunction Questionnaire-7 score correlated well with the SNOT-22 and Lund-Kennedy scales.</div></div><div><h3>Conclusions</h3><div>Regression analysis revealed that a type 2 inflammation profile might play a more important role in tubal patency than nasal obstruction. Polyposis may alter Eustachian tube function, but more likely due to its inflammatory-allergic etiopathogenesis than to its obstructive nature.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 4","pages":"Article 512235"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713624","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}
To analyze the volume of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) to whom biologics would be prescribed based on the European and Spanish clinical practice guidelines, and to evaluate the impact that an increase of 1 required prior surgery (from 1 to 2) may have on the number of indications.
Methods
Cross-sectional analysis evaluating the application of the European Position Paper on CRSwNP Guidelines (EPOS 2020) and the Spanish Consensus on the Management of CRSwNP Guidelines (POLINA 2.0) on an on-going prospective cohort study of consecutive patients with severe CRSwNP in a tertiary hospital.
Results
For a total of 103 patients with severe CRSwNP, 57.3% met EPOS 2020 criteria for biological treatment, whereas only 32% met POLINA 2.0 criteria. However, if the number of surgeries required to prescribe a biological therapy is increased to 2, only 31.1% of the patients would have indication of biological treatment, in any of the two guidelines.
Conclusions
The differences among the POLINA 2.0 and the EPOS 2020 guidelines appear to have an impact in the proportion of patients eligible for biological therapies, with the former being stricter. Increasing the number of prior surgeries required, reduces the proportion of patients eligible for monoclonal antibodies prescription.
{"title":"Comparison of the EPOS 2020 and POLINA 2.0 guidelines for indicating biologic treatment in adults with chronic rhinosinusitis and nasal polyps","authors":"Mireia Golet , Núria Padullés-Zamora , Alejandro Portillo , José María Caballero , Mariana Muñoz Esquerre , Joaquín Sastre , Isam Alobid , Xavier González-Compta","doi":"10.1016/j.otorri.2025.512224","DOIUrl":"10.1016/j.otorri.2025.512224","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the volume of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) to whom biologics would be prescribed based on the European and Spanish clinical practice guidelines, and to evaluate the impact that an increase of 1 required prior surgery (from 1 to 2) may have on the number of indications.</div></div><div><h3>Methods</h3><div>Cross-sectional analysis evaluating the application of the European Position Paper on CRSwNP Guidelines (EPOS 2020) and the Spanish Consensus on the Management of CRSwNP Guidelines (POLINA 2.0) on an on-going prospective cohort study of consecutive patients with severe CRSwNP in a tertiary hospital.</div></div><div><h3>Results</h3><div>For a total of 103 patients with severe CRSwNP, 57.3% met EPOS 2020 criteria for biological treatment, whereas only 32% met POLINA 2.0 criteria. However, if the number of surgeries required to prescribe a biological therapy is increased to 2, only 31.1% of the patients would have indication of biological treatment, in any of the two guidelines.</div></div><div><h3>Conclusions</h3><div>The differences among the POLINA 2.0 and the EPOS 2020 guidelines appear to have an impact in the proportion of patients eligible for biological therapies, with the former being stricter. Increasing the number of prior surgeries required, reduces the proportion of patients eligible for monoclonal antibodies prescription.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 4","pages":"Article 512224"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713668","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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