Acta otorrinolaringologica espanola最新文献

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.

Benign paroxysmal positional vertigo is the most common cause of peripheral vertigo. It is characterized by short and recurrent episodes of vertigo, trigged by specific head movements that displace otoconia within the semicircular canals. The movement of dislodge otoconia from the utricle cause abnormal positional endolymphatic currents. Primary treatment involves reposition maneuvers aimed at moving the displaced otoconia out the affected canal, therefore correct identification of the affected canal is essential for the diagnosis. The posterior semicircular canal (PSC) is the most frequently affected due to its spatial orientation and the force of gravity. Recent technological advances have allowed for better assessment of positional nystagmus during diagnostic and therapeutic maneuvers, revealing various possible scenarios of PSC involvement. Regarding the PSC, otoconia may be found in different parts of the canal, and not just in the expected location, floating in the long arm of the canal. The understanding of these variants is crucial, as the prognosis and the disease progression differ in such cases. This review aims to describe the six possible variants of PSC involvement described so far.

Introduction and objectives

Even though the incidence has decreased in recent years, Down syndrome remains the most common chromosomal disorder today. Despite being a condition with multisystemic involvement, it often tends to affect the head and neck area, making it a frequent reason for consultation with pediatric otolaryngologists or otologists. The purpose of this work is to be one of the first in Spain to characterize and describe the pathology and therapeutic approach typically provided to these patients, analyzing the evolution from a clinical and auditory perspective.

Material and methods

We aim to analyze a sample of 16 pediatric patients recruited over the past 24 years, diagnosed with Down syndrome, and experiencing a wide range of diseases affecting the ear and its auditory function.

Results

62.50% of the patients were women, whose main reason for seeking specialist care was acute and serous otitis media, accounting for 31.25%. These patients have an indication for treatment for various entities within the otological sphere that usually do not differ from those of a healthy child. However, the evolution and response to treatments can take on a torpid character due to the anatomical characteristics of the ears of these patients.

Conclusions

Although the frequency of children with Down syndrome in the pediatric otolaryngologist's clinic is decreasing, these patients have a predisposition to ear diseases with auditory repercussions, with variable evolution depending on the disease and the child's intrinsic characteristics.

Introduction

Anti-IgLON5 disease is a recently described neurological disorder with multisystemic features. The disease is characterized by the presence of IgLON5 antibodies in serum and cerebrospinal fluid. Our objective is to describe in detail the otorhinolaryngological manifestations of this disease, which are frequent and may include dysphagia, dysarthria, vocal cord paralysis and laryngospasm.

Methods

In this study, we present a series of 9 patients with anti-IgLON5 disease and otolaryngological manifestations. Patients were evaluated between July 2012 and March 2022 by video-polysomnography, fiber-optic laryngoscopy, and functional endoscopic evaluation of swallowing.

Results

The median age was 71 years, and 5 (56%) were female. Video-polysomnography showed a NREM/REM parasomnia in 6 patients (67%), obstructive sleep apnea in 8 (88%), stridor during sleep in 7 (78%) and central apneas in 1 (11%). Six out of the 9 patients (67%) presented episodes of acute respiratory failure that required mechanical ventilation, 6 had vocal fold palsy with 4 of them requiring tracheostomy (3 had to be performed on an emergency basis). Dysphagia occurred in 8 patients (89%). Prominent upper airway secretion and sialorrhea was also present in 3 cases.

Conclusion

The anti-IgLON5 disease exhibits extensive otolaryngological symptoms, mainly affecting the upper airway. These symptoms affect the quality of life and can be life-threatening. Prompt acute management is essential for stridor, dyspnea, and dysphagia. Given the potential severity of the symptoms and rarity of the disease, it is important for otolaryngologists to be familiar with anti-IgLON5 disease.

Level of evidence

Level 4.

Introduction

It is extremely important to assess speech perception skills in children with hearing loss, since these skills are essential to guide the rehabilitation process.

Objective

Update and validate the Early Speech Perception test in Spanish in normal-hearing children.

Method

Different drawings were selected from children's books used daily in the work of teachers and speech therapists. 69 children aged between 3 and 8 years old participated in the study, divided into 6 groups by age (group 1, 3 years of age [n = 13]; group 2, 4 years of age [n = 15]; group 3, 5 years of age [n = 12]; group 4, 6 years of age [n = 8]; group 5, 7 years of age [n = 10]; group 6, 8 years of age [n = 11]). For each category of the test, the children had to name and point to the corresponding drawing.

Results

The difference between age and gender groups was statistically evaluated. For the naming phase, a significant difference was observed between groups 1 and group 5; and between group 1 and group 6. For the pointing phase there was no difference between the groups, and in all groups, there was a score greater than 98%. In relation to gender, there was no difference between the groups.

Conclusion

The present study demonstrates that the material developed to assess auditory reception in normal-hearing children from 3 to 8 years old is appropriate.

Background and objective

Chronic rhinosinusitis is a common inflammatory disorder in sinonasal mucosa that could be developed with or without nasal polyps. Cellular proliferation is suggested as a possible mechanism of nasal polyp development. However, conducted studies in this context are limited. So, the present study's aim is the comparison of proliferating cell nuclear antigen (PCNA) expression in nasal polyps and chronic rhinosinusitis.

Materials and methods

In this cross-sectional study, 70 nasal polyp and 60 chronic rhinosinusitis samples from patients referred to Mostafa Khomeini Hospital, Tehran from 2017 to 2022 were immunohistochemically stained by PCNA marker. The percentage of PCNA nuclear expression was determined in two groups and its association with the type of pathological lesion and the patient's age and sex was analyzed by SPSS statistic software version 24 statistical software (IBM Statistics, USA).

Results

The mean percentage expression of PCNA in nasal polyp and chronic rhinosinusitis samples was 16.55 ± 13.66 and 17.58 ± 12.68 respectively (ranging from 0 to 57 in both groups) however, there was no significant statistical difference between the two groups (p = 0.479). No relationship was found between PCNA expression with age and sex in none of the chronic rhinosinusitis and nasal polyp groups.

Conclusion

Proliferative activity of the nasal epithelial cell is similar in chronic rhinosinusitis with and without nasal polyps and it is considered that the increase of epithelial cell proliferative activity probably has no role in nasal polyp development in patients with chronic rhinosinusitis.

Objectives

To compare the hearing outcomes of ossicular chain reconstruction using bone cement versus other materials such as prostheses and autografts.

Methods

This study included articles that compared hearing outcomes in patients with conductive hearing loss who underwent stapes revision surgery or chronic otitis media surgery. A systematic search for articles from January 2000 to February 2022 was conducted in Medline, Embase, and Cochrane Library databases. Only articles in English were included. An effective postoperative air-bone gap (ABG) was defined as ≤20 dB. A bias assessment tool was developed according to Cochrane guidelines, and the chi-square test was used to evaluate the mean age of the samples.

Results

Of the 418 studies that met the selection criteria, only seven were eligible for this study, consisting of 187 patients in the bone cement group and 173 in the non-bone cement group. Ossiculoplasty using bone cement yielded significantly better results, with a combined odds ratio (OR) of 2.03 (95% CI: 1.16–3.55, p = 0.01).

Conclusions

The results of this study suggest that the effectiveness of bone cement in ossiculoplasty was greater than that of other materials in chronic otitis media surgery or stapes revision surgery, with a higher number of patients achieving ABG ≤20 dB.