Pub Date : 2025-03-12DOI: 10.1016/j.amjoto.2025.104606
Neemias Santos Carneiro , José Faibes Lubianca Neto , Bárbara Salgueiro , Rita Carolina Pozzer Krumenauer Padoin , Renata Loss Drummond , Mateus Campestrini Harger , Marcelo Neves Lubianca
<div><h3>Objectives</h3><div>Percutaneous vocal fold lateralization (PVFL) consists of external fixation with non-absorbable percutaneous suture of the vocal fold in a lateral position, under direct glottic visualization. The objective, through a systematic review, was to identify, select, evaluate, and synthesize the relevant evidence available to define whether PVFL is effective in avoiding the tracheostomy, as well as whether it is effective in allowing decannulation of children who have already been tracheostomized. Secondarily, vocal quality, complications and reversibility of the procedure were evaluated.</div></div><div><h3>Methods</h3><div>A systematic review was carried out based on the protocols described in the QUORUM/PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The search strategy was carried out in the PubMed, Embase, Scopus, Web of Science, SciELO and VHL databases. The terms searched were a combination of indexed keywords using Boolean terms. Inclusion criteria: Primary studies that documented intervention outcomes in patients with BVFP; Studies including pediatric patients (defined here as <18 years of age); and studies with well documented postoperative follow-up. Exclusion criteria: Duplicate studies or with the same clinical data; articles that exclusively evaluated other surgical interventions, animal studies, reviews, or post-mortem studies; and studies with only patients with unilateral vocal fold paralysis.</div></div><div><h3>Results</h3><div>Among the patients under study, 80 cases, underwent the surgical technique under study, 41 of these (51.25 %) are male. The average age of patients undergoing the procedures ranged from 4 days to 10 years of age. Most patients already had preoperative comorbidities, generally cardiothoracic and laryngeal, followed by neurological causes. In 31 % of patients, only a high-flow nasal catheter was required and in 3 patients, transient orotracheal intubation was required. At the mean follow-up of 30 months [SD:24], around 20 of the 80 (25.6 %) patients presented some degree of dysphonia. However, there was no standardization of scales. Approximately 11 % of patients had some postoperative complication, with reintubation due to glottic edema being the most prevalent. There was only 1 death. Preoperatively, 38 % of patients with BVFP were tracheostomized. After the procedure, only 13 % of them still needed to continue with the tracheostomy during the postoperative period. However, 13 % of patients needed to remain with a tracheostomy. Among the tracheostomy patients, only 3 of them achieved return of vocal fold mobility. Among all patients, vocal fold mobility returned in 35 % of patients, with a total of 10 % of patients postoperatively. However, there were studies that did not report mobility due to the short follow-up. During follow-up, 6 patients required revision procedures to relocate lateralization suture or even due to skin abscess. Granu
{"title":"Vocal fold lateralization by percutaneous suture in children: A systematic review","authors":"Neemias Santos Carneiro , José Faibes Lubianca Neto , Bárbara Salgueiro , Rita Carolina Pozzer Krumenauer Padoin , Renata Loss Drummond , Mateus Campestrini Harger , Marcelo Neves Lubianca","doi":"10.1016/j.amjoto.2025.104606","DOIUrl":"10.1016/j.amjoto.2025.104606","url":null,"abstract":"<div><h3>Objectives</h3><div>Percutaneous vocal fold lateralization (PVFL) consists of external fixation with non-absorbable percutaneous suture of the vocal fold in a lateral position, under direct glottic visualization. The objective, through a systematic review, was to identify, select, evaluate, and synthesize the relevant evidence available to define whether PVFL is effective in avoiding the tracheostomy, as well as whether it is effective in allowing decannulation of children who have already been tracheostomized. Secondarily, vocal quality, complications and reversibility of the procedure were evaluated.</div></div><div><h3>Methods</h3><div>A systematic review was carried out based on the protocols described in the QUORUM/PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The search strategy was carried out in the PubMed, Embase, Scopus, Web of Science, SciELO and VHL databases. The terms searched were a combination of indexed keywords using Boolean terms. Inclusion criteria: Primary studies that documented intervention outcomes in patients with BVFP; Studies including pediatric patients (defined here as <18 years of age); and studies with well documented postoperative follow-up. Exclusion criteria: Duplicate studies or with the same clinical data; articles that exclusively evaluated other surgical interventions, animal studies, reviews, or post-mortem studies; and studies with only patients with unilateral vocal fold paralysis.</div></div><div><h3>Results</h3><div>Among the patients under study, 80 cases, underwent the surgical technique under study, 41 of these (51.25 %) are male. The average age of patients undergoing the procedures ranged from 4 days to 10 years of age. Most patients already had preoperative comorbidities, generally cardiothoracic and laryngeal, followed by neurological causes. In 31 % of patients, only a high-flow nasal catheter was required and in 3 patients, transient orotracheal intubation was required. At the mean follow-up of 30 months [SD:24], around 20 of the 80 (25.6 %) patients presented some degree of dysphonia. However, there was no standardization of scales. Approximately 11 % of patients had some postoperative complication, with reintubation due to glottic edema being the most prevalent. There was only 1 death. Preoperatively, 38 % of patients with BVFP were tracheostomized. After the procedure, only 13 % of them still needed to continue with the tracheostomy during the postoperative period. However, 13 % of patients needed to remain with a tracheostomy. Among the tracheostomy patients, only 3 of them achieved return of vocal fold mobility. Among all patients, vocal fold mobility returned in 35 % of patients, with a total of 10 % of patients postoperatively. However, there were studies that did not report mobility due to the short follow-up. During follow-up, 6 patients required revision procedures to relocate lateralization suture or even due to skin abscess. Granu","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104606"},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uvulopalatopharyngoplasty and its modifications, including expansion sphincter pharyngoplasty, are the most common surgical interventions for obstructive sleep apnea.
Objective
To introduce a novel surgery technique in which expansion sphincter pharyngoplasty was performed accompanied by inserting a cartilage implant into the palate.
Methods
Adult patients required septoplasty and pharyngoplasty were selected. In intervention group, expansion sphincter pharyngoplasty was performed with the insertion of a cartilage implant, obtained from their septum into the uvulopalatal flap site. In control group, similar procedures were performed except for cartilage insertion. Surgery outcome was assessed at the 3rd and 6th month post-operation by STOP-Bang Questionnaire (SBQ), Epworth Sleepiness Scale (ESS), and snoring level.
Results
Thirty-one individuals with a mean age of 36.9 ± 9.0 years, consisting of 27 (87.1 %) men, were recruited. At follow-ups sessions of intervention group (n = 16), the SBQ decreased from 3.94 ± 1.39 to 2.33 ± 1.11 and 1.80 ± 1.21 (p < 0.001), ESS decreased from 10.31 ± 5.52 to 5.20 ± 2.83 and 3.33 ± 1.76 (p < 0.001), and snoring level decreased from 2 to 1 and 1 (p < 0.001). In control group (n = 15), the SBQ decreased from 4.23 ± 0.60 to 2.38 ± 0.96 and 2.08 ± 1.11 (p < 0.001), ESS decreased from 13.08 ± 5.88 to 7.69 ± 4.27 and 5.69 ± 4.05 (p < 0.001), and snoring level decreased from 3 to 2 and 1 (p < 0.001). Between group comparison indicated that ESS was marginal at the second follow-up (p = 0.051), and the snoring level was significantly different at first (p = 0.019) and second (p = 0.031) follow-ups.
Conclusion
Performing expansion sphincter pharyngoplasty with a cartilage implant in selected individuals improved surgery outcome.
{"title":"Expansion sphincter pharyngoplasty with cartilage implant in uvulopalatal flap for treatment of obstructive sleep apnea","authors":"Fereshte Shenavayi , Shayan Dasdar , Hamed Amirifard , Reza Erfanian , Arezu Najafi , Nika Kianfar , Amin Amali , Shohre Ghasemi , Reihaneh Heidari","doi":"10.1016/j.amjoto.2025.104608","DOIUrl":"10.1016/j.amjoto.2025.104608","url":null,"abstract":"<div><h3>Background</h3><div>Uvulopalatopharyngoplasty and its modifications, including expansion sphincter pharyngoplasty, are the most common surgical interventions for obstructive sleep apnea.</div></div><div><h3>Objective</h3><div>To introduce a novel surgery technique in which expansion sphincter pharyngoplasty was performed accompanied by inserting a cartilage implant into the palate.</div></div><div><h3>Methods</h3><div>Adult patients required septoplasty and pharyngoplasty were selected. In intervention group, expansion sphincter pharyngoplasty was performed with the insertion of a cartilage implant, obtained from their septum into the uvulopalatal flap site. In control group, similar procedures were performed except for cartilage insertion. Surgery outcome was assessed at the 3rd and 6th month post-operation by STOP-Bang Questionnaire (SBQ), Epworth Sleepiness Scale (ESS), and snoring level.</div></div><div><h3>Results</h3><div>Thirty-one individuals with a mean age of 36.9 ± 9.0 years, consisting of 27 (87.1 %) men, were recruited. At follow-ups sessions of intervention group (<em>n</em> = 16), the SBQ decreased from 3.94 ± 1.39 to 2.33 ± 1.11 and 1.80 ± 1.21 (<em>p</em> < 0.001), ESS decreased from 10.31 ± 5.52 to 5.20 ± 2.83 and 3.33 ± 1.76 (p < 0.001), and snoring level decreased from 2 to 1 and 1 (<em>p</em> < 0.001). In control group (<em>n</em> = 15), the SBQ decreased from 4.23 ± 0.60 to 2.38 ± 0.96 and 2.08 ± 1.11 (<em>p</em> < 0.001), ESS decreased from 13.08 ± 5.88 to 7.69 ± 4.27 and 5.69 ± 4.05 (p < 0.001), and snoring level decreased from 3 to 2 and 1 (p < 0.001). Between group comparison indicated that ESS was marginal at the second follow-up (<em>p</em> = 0.051), and the snoring level was significantly different at first (<em>p</em> = 0.019) and second (<em>p</em> = 0.031) follow-ups.</div></div><div><h3>Conclusion</h3><div>Performing expansion sphincter pharyngoplasty with a cartilage implant in selected individuals improved surgery outcome.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104608"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-11DOI: 10.1016/j.amjoto.2025.104611
Yuyang Jiang , Qiang Liu , Yi Ding, Yongdong Sun
Objective
This paper assesses the correlation between tinnitus and mental health, including depression, anxiety, stress, insomnia, and suicide through meta-analysis.
Methods
Web of Science, Embase, PubMed, and Cochrane databases were searched until January 2024. After article screening, data extraction, and quality evaluation, meta-analysis was performed using Stata 15.1.
Results
22 papers were enrolled, including 5 case-control studies, 8 cohort studies, and 9 cross-sectional studies. Meta-analysis uncovered that tinnitus was associated with depression (OR = 1.92, 95 % CI: 1.56, 2.36), anxiety (OR = 1.63, 95 % CI: 1.34, 1.98), stress (OR = 1.17, 95 % CI: 1.01, 1.36), insomnia (OR = 3.07, 95 % CI: 2.36, 3.98), and suicide (OR = 5.31, 95 % CI: 4.34, 6.51).
Conclusion
A correlation is indicated between tinnitus and mental health. Therefore, it is critical to incorporate psychological interventions in tinnitus treatment and to implement a comprehensive treatment program.
{"title":"Systematic review and meta-analysis of the correlation between tinnitus and mental health","authors":"Yuyang Jiang , Qiang Liu , Yi Ding, Yongdong Sun","doi":"10.1016/j.amjoto.2025.104611","DOIUrl":"10.1016/j.amjoto.2025.104611","url":null,"abstract":"<div><h3>Objective</h3><div>This paper assesses the correlation between tinnitus and mental health, including depression, anxiety, stress, insomnia, and suicide through meta-analysis.</div></div><div><h3>Methods</h3><div>Web of Science, Embase, PubMed, and Cochrane databases were searched until January 2024. After article screening, data extraction, and quality evaluation, meta-analysis was performed using Stata 15.1.</div></div><div><h3>Results</h3><div>22 papers were enrolled, including 5 case-control studies, 8 cohort studies, and 9 cross-sectional studies. Meta-analysis uncovered that tinnitus was associated with depression (OR = 1.92, 95 % CI: 1.56, 2.36), anxiety (OR = 1.63, 95 % CI: 1.34, 1.98), stress (OR = 1.17, 95 % CI: 1.01, 1.36), insomnia (OR = 3.07, 95 % CI: 2.36, 3.98), and suicide (OR = 5.31, 95 % CI: 4.34, 6.51).</div></div><div><h3>Conclusion</h3><div>A correlation is indicated between tinnitus and mental health. Therefore, it is critical to incorporate psychological interventions in tinnitus treatment and to implement a comprehensive treatment program.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104611"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-11DOI: 10.1016/j.amjoto.2025.104609
Kevin P.J. Finnegan, Gavin P. Dowling, Sami Abd El Wahab , Arnold D.K. Hill
Objective
The aim of this systematic review was to investigate the value of intraoperative parathyroid hormone (IOPTH) monitoring in parathyroidectomy for tertiary hyperparathyroidism (THPT) to predict cure and recurrence.
Data sources
Ovid, Embase, EBSCO Host, Citation Checking.
Methods
This study was performed in accordance with PRISMA guidelines. A systematic search of the literature was conducted to identify studies evaluating IOPTH monitoring in patients with THPT. Only studies addressing THPT with documented use of IOPTH in their surgery were included.
Results
In 11 of the 18 studies included in this review IOPTH monitoring influenced the surgery by identifying insufficient resection or ectopic/supernumerary glands necessitating further resection to cure patients. Rates of recurrence were absent or minimal in patients who achieved appropriate IOPTH drops at specified time intervals.
Conclusion
IOPTH monitoring is a useful adjunct to prevent insufficient resection of hyperplastic glands and to identify ectopic/supernumerary glands. Median PTH drop at specified time intervals can help predict cure and recurrence in parathyroidectomy for THPT.
{"title":"Intraoperative parathyroid hormone monitoring in parathyroidectomy: Predicting cure and recurrence in tertiary hyperparathyroidism - systematic review","authors":"Kevin P.J. Finnegan, Gavin P. Dowling, Sami Abd El Wahab , Arnold D.K. Hill","doi":"10.1016/j.amjoto.2025.104609","DOIUrl":"10.1016/j.amjoto.2025.104609","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this systematic review was to investigate the value of intraoperative parathyroid hormone (IOPTH) monitoring in parathyroidectomy for tertiary hyperparathyroidism (THPT) to predict cure and recurrence.</div></div><div><h3>Data sources</h3><div>Ovid, Embase, EBSCO Host, Citation Checking.</div></div><div><h3>Methods</h3><div>This study was performed in accordance with PRISMA guidelines. A systematic search of the literature was conducted to identify studies evaluating IOPTH monitoring in patients with THPT. Only studies addressing THPT with documented use of IOPTH in their surgery were included.</div></div><div><h3>Results</h3><div>In 11 of the 18 studies included in this review IOPTH monitoring influenced the surgery by identifying insufficient resection or ectopic/supernumerary glands necessitating further resection to cure patients. Rates of recurrence were absent or minimal in patients who achieved appropriate IOPTH drops at specified time intervals.</div></div><div><h3>Conclusion</h3><div>IOPTH monitoring is a useful adjunct to prevent insufficient resection of hyperplastic glands and to identify ectopic/supernumerary glands. Median PTH drop at specified time intervals can help predict cure and recurrence in parathyroidectomy for THPT.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104609"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-10DOI: 10.1016/j.amjoto.2025.104610
Shaina W. Gong , Paul Hung , Chioma G. Obinero , Jose Barrera , Zi Yang Jiang , Matthew R. Greives , Zhen Huang
Background
In patients with cleft palate (CP), the impact of primary palatoplasty technique on otologic outcomes remains a major point of contention. While some studies report improved outcomes after certain techniques of palatal repair, there is a lack of consensus on the most effective procedure.
Objective
We sought to characterize the effects of primary palatoplasty technique on otologic outcomes in children with CP.
Methods
A single institution retrospective review of patients with CP who underwent primary palatoplasty (straight-line repair or Furlow Z-plasty) was performed. Primary outcomes of interest included time to placement of T-tubes, number of tympanostomy tube placements, tympanic membrane (TM) perforation, and 3-year and 6-year postoperative hearing thresholds.
Results
A total of 140 patients were included in this study. The mean number of tympanostomy tube placements in the straight-line repair group (1.93 ± 1.28) was significantly higher than in the Furlow Z-plasty group (1.42 ± 1.03, p = 0.03). Median time from primary palate repair to T-tube placement was 38.93 (IQR 33.03) months. Higher birth weight (p < 0.01) and multiple tympanostomy tube placements (p < 0.05) were associated with longer time to T-tube placement. T-tube replacement was associated with a 16.9 times higher likelihood of TM perforation (p < 0.05). The median PTA significantly improved from 16.25 (IQR 7) dB at 3 years to 11.00 (IQR 5.25) dB at 6 years (p < 0.01).
Conclusions
Furlow palatoplasty technique was associated with fewer number of tympanostomy tube placements; however, palatoplasty technique did not significantly impact time to T-tube placement, TM perforation, or hearing outcomes. There were no significant differences in long-term hearing outcomes between patients who underwent Furlow Z-plasty and those who had straight-line repair. Most patients achieved normal hearing thresholds by 6 years after primary palatoplasty and tympanostomy tube placement. These are important considerations to discuss when counseling patients' families on surgical management of CP and otologic outcomes.
{"title":"Effect of palatoplasty technique on otologic outcomes in children with cleft palate","authors":"Shaina W. Gong , Paul Hung , Chioma G. Obinero , Jose Barrera , Zi Yang Jiang , Matthew R. Greives , Zhen Huang","doi":"10.1016/j.amjoto.2025.104610","DOIUrl":"10.1016/j.amjoto.2025.104610","url":null,"abstract":"<div><h3>Background</h3><div>In patients with cleft palate (CP), the impact of primary palatoplasty technique on otologic outcomes remains a major point of contention. While some studies report improved outcomes after certain techniques of palatal repair, there is a lack of consensus on the most effective procedure.</div></div><div><h3>Objective</h3><div>We sought to characterize the effects of primary palatoplasty technique on otologic outcomes in children with CP.</div></div><div><h3>Methods</h3><div>A single institution retrospective review of patients with CP who underwent primary palatoplasty (straight-line repair or Furlow Z-plasty) was performed. Primary outcomes of interest included time to placement of T-tubes, number of tympanostomy tube placements, tympanic membrane (TM) perforation, and 3-year and 6-year postoperative hearing thresholds.</div></div><div><h3>Results</h3><div>A total of 140 patients were included in this study. The mean number of tympanostomy tube placements in the straight-line repair group (1.93 ± 1.28) was significantly higher than in the Furlow Z-plasty group (1.42 ± 1.03, <em>p</em> = 0.03). Median time from primary palate repair to T-tube placement was 38.93 (IQR 33.03) months. Higher birth weight (<em>p</em> < 0.01) and multiple tympanostomy tube placements (<em>p</em> < 0.05) were associated with longer time to T-tube placement. T-tube replacement was associated with a 16.9 times higher likelihood of TM perforation (<em>p</em> < 0.05). The median PTA significantly improved from 16.25 (IQR 7) dB at 3 years to 11.00 (IQR 5.25) dB at 6 years (<em>p</em> < 0.01).</div></div><div><h3>Conclusions</h3><div>Furlow palatoplasty technique was associated with fewer number of tympanostomy tube placements; however, palatoplasty technique did not significantly impact time to T-tube placement, TM perforation, or hearing outcomes. There were no significant differences in long-term hearing outcomes between patients who underwent Furlow Z-plasty and those who had straight-line repair. Most patients achieved normal hearing thresholds by 6 years after primary palatoplasty and tympanostomy tube placement. These are important considerations to discuss when counseling patients' families on surgical management of CP and otologic outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104610"},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sudden Sensorineural Hearing Loss (SSNHL) is an otologic emergency characterized by a rapid decrease in hearing threshold. The etiology of SSNHL is often unclear, with potential links to vascular pathologies. This study investigates the association between white matter lesions (WMLs) observed in brain MRI and cardiovascular risk factors in SSNHL patients.
Methods
This case-control study involved 34 SSNHL patients and 34 matched controls, none of them had migraine. Both groups underwent pure tone audiometry and brain MRI. WMLs were assessed using the Fazekas scale. Cardiovascular risk factors, including hypertension, diabetes, dyslipidemia, BMI, and smoking, were documented.
Results
While none of the cardiovascular risk factors showed a significant difference between the two groups, the presence of WMLs was significantly higher in the SSNHL group compared to controls (79.4 % vs. 32.4 %; p < 0.001). More specifically, 24 patients (70.6 %) and 10 controls (29.4 %) had periventricular white matter (PVWM) lesions, while 20 patients (58.8 %) and 8 controls (23.5 %) had deep white matter (DWM) lesions. Logistic regression analysis revealed that increased grades of PVWM lesions were associated with a 5.7-fold higher likelihood of moderate or greater hearing loss (p = 0.033). The degree of DWM lesions, according to the Fazekas scale, demonstrated a significant correlation with hearing recovery rate.
Conclusion
White matter lesions (WMLs) are significantly associated with sudden sensorineural hearing loss (SSNHL), with higher grades of PVWM lesions increasing the likelihood of severe hearing loss and DWM lesions correlating with hearing recovery. These associations seem to be independent of cardiovascular risk factors.
{"title":"White matter lesions in brain MRI and cardiovascular risk factors in sudden sensorineural hearing loss patients: A comparative study","authors":"Shadman Nemati , Negar Hosseinpoor , Mehrgan Khanhakimi , Sima Fallah Arzpeyma , Mohammad Ebrahim Ghaffari , Seyed Hassan Mostafavi , Pejman Kiani , Alia Saberi","doi":"10.1016/j.amjoto.2025.104607","DOIUrl":"10.1016/j.amjoto.2025.104607","url":null,"abstract":"<div><h3>Background</h3><div>Sudden Sensorineural Hearing Loss (SSNHL) is an otologic emergency characterized by a rapid decrease in hearing threshold. The etiology of SSNHL is often unclear, with potential links to vascular pathologies. This study investigates the association between white matter lesions (WMLs) observed in brain MRI and cardiovascular risk factors in SSNHL patients.</div></div><div><h3>Methods</h3><div>This case-control study involved 34 SSNHL patients and 34 matched controls, none of them had migraine. Both groups underwent pure tone audiometry and brain MRI. WMLs were assessed using the Fazekas scale. Cardiovascular risk factors, including hypertension, diabetes, dyslipidemia, BMI, and smoking, were documented.</div></div><div><h3>Results</h3><div>While none of the cardiovascular risk factors showed a significant difference between the two groups, the presence of WMLs was significantly higher in the SSNHL group compared to controls (79.4 % vs. 32.4 %; p < 0.001). More specifically, 24 patients (70.6 %) and 10 controls (29.4 %) had periventricular white matter (PVWM) lesions, while 20 patients (58.8 %) and 8 controls (23.5 %) had deep white matter (DWM) lesions. Logistic regression analysis revealed that increased grades of PVWM lesions were associated with a 5.7-fold higher likelihood of moderate or greater hearing loss (p = 0.033). The degree of DWM lesions, according to the Fazekas scale, demonstrated a significant correlation with hearing recovery rate.</div></div><div><h3>Conclusion</h3><div>White matter lesions (WMLs) are significantly associated with sudden sensorineural hearing loss (SSNHL), with higher grades of PVWM lesions increasing the likelihood of severe hearing loss and DWM lesions correlating with hearing recovery. These associations seem to be independent of cardiovascular risk factors.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104607"},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-05DOI: 10.1016/j.amjoto.2025.104605
G.P. Krisciunas , E. Rodriguez-Diaz , L. Berry , G. Spokas , O.M. A'Amar , M. Couey , H. Edwards , J. Gooey , J. Hanks , Z. Lu , D. Lucas , M. O'Leary , R. Pistey , M. Sakharkar , K. Sayre , J. Tracy , G. Zhao , I.J. Bigio , G.A. Grillone
Objective
To assess Elastic Scattering Spectroscopy (ESS) classification accuracy of benign vs malignant tissue obtained during intra-operative oral cancer resection.
Methods
The study comprised 104 patients with a biopsy positive for oral cancer (N = 85) or dysplasia (N = 19) who were scheduled to undergo surgical excision. ESS measurements were obtained intraoperatively on and immediately adjacent to the lesion within the planned resection margin prior to excision, and on contralateral normal-site control tissue. Two-millimeter biopsies were obtained from tumor and margin tissue. All measurements were evaluated using Leave One Person Out (LOPO) AI-assisted statistical algorithms. Three analyses evaluated ESS diagnostic accuracy: one at the sample level, one at the pooled sample patient level, and one using only diagnostically variable biopsy co-registered margin samples. Statistical analyses included sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and Area Under the Receiver Operating Characteristic Curve (AUC-ROC).
Results
Diagnostic accuracy at the sample level yielded sensitivity = 82 %, specificity = 84 %, and AUC = 0.91. Pooling samples within each patient yielded sensitivity = 94 %, specificity = 87 %, and AUC = 0.95. Sample level diagnostic accuracy at the margin yielded sensitivity = 76 %, specificity = 50 %, and AUC = 0.70, but prioritizing sensitivity, yielded a sensitivity = 90 %, specificity = 30 %, with AUC = 0.70.
Conclusion
The ESS device demonstrated high sensitivity and appropriate specificity when differentiating benign from malignant tissue. Discriminant ability increased when samples were pooled within patients, informing future protocols for evaluating intraoperative ESS measures. These data are very promising and support the contention that ESS could be a valuable adjunct tool that facilitates comprehensive and efficient assessment of surgical margins.
{"title":"Elastic scattering spectroscopy for intraoperative oral cancer mucosal margin guidance: Initial results from a 104 patient cohort","authors":"G.P. Krisciunas , E. Rodriguez-Diaz , L. Berry , G. Spokas , O.M. A'Amar , M. Couey , H. Edwards , J. Gooey , J. Hanks , Z. Lu , D. Lucas , M. O'Leary , R. Pistey , M. Sakharkar , K. Sayre , J. Tracy , G. Zhao , I.J. Bigio , G.A. Grillone","doi":"10.1016/j.amjoto.2025.104605","DOIUrl":"10.1016/j.amjoto.2025.104605","url":null,"abstract":"<div><h3>Objective</h3><div>To assess Elastic Scattering Spectroscopy (ESS) classification accuracy of benign vs malignant tissue obtained during intra-operative oral cancer resection.</div></div><div><h3>Methods</h3><div>The study comprised 104 patients with a biopsy positive for oral cancer (<em>N</em> = 85) or dysplasia (<em>N</em> = 19) who were scheduled to undergo surgical excision. ESS measurements were obtained intraoperatively on and immediately adjacent to the lesion within the planned resection margin prior to excision, and on contralateral normal-site control tissue. Two-millimeter biopsies were obtained from tumor and margin tissue. All measurements were evaluated using Leave One Person Out (LOPO) AI-assisted statistical algorithms. Three analyses evaluated ESS diagnostic accuracy: one at the sample level, one at the pooled sample patient level, and one using only diagnostically variable biopsy co-registered margin samples. Statistical analyses included sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and Area Under the Receiver Operating Characteristic Curve (AUC-ROC).</div></div><div><h3>Results</h3><div>Diagnostic accuracy at the sample level yielded sensitivity = 82 %, specificity = 84 %, and AUC = 0.91. Pooling samples within each patient yielded sensitivity = 94 %, specificity = 87 %, and AUC = 0.95. Sample level diagnostic accuracy at the margin yielded sensitivity = 76 %, specificity = 50 %, and AUC = 0.70, but prioritizing sensitivity, yielded a sensitivity = 90 %, specificity = 30 %, with AUC = 0.70.</div></div><div><h3>Conclusion</h3><div>The ESS device demonstrated high sensitivity and appropriate specificity when differentiating benign from malignant tissue. Discriminant ability increased when samples were pooled within patients, informing future protocols for evaluating intraoperative ESS measures. These data are very promising and support the contention that ESS could be a valuable adjunct tool that facilitates comprehensive and efficient assessment of surgical margins.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104605"},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this study, we explore the use of extended reality (XR) therapy, which includes augmented (AR), virtual (VR), and mixed reality (MR), in patients experiencing symptoms of facial paralysis.
Data sources
Pubmed, Scopus, Embase.
Methods
A scoping review across PubMed, Scopus, Embase was performed following PRISMA-ScR systematic review guidelines with the use of Covidence.
Results
160 articles were identified and 7 articles, spanning from 2015 to 2023, ultimately met the criteria for this review. The articles reviewed highlight various XR applications and grading systems designed to enhance facial muscle strength, symmetry, and emotional well-being in Bell's palsy patients. Notable programs include FaraPy, FACE2FACE®App, eFace App, Canfeld, RealSense, GY MEDIC, and FaceRehab. These programs exhibit significant potential as effective rehabilitation and assessment tools in facial paralysis patients.
Conclusion
The use of extended reality (XR) technologies, along with 3D and 4D imaging, represents a major advancement in the field of facial paralysis therapy. These innovations offer exciting possibilities for enhancing patient care and optimizing outcomes for patients experiencing facial paralysis and muscle deficits. As these technologies start to be integrated into clinical contexts, further research and validation is required to ensure their efficacy and utilization.
{"title":"Exploring extended reality as a therapy for patients with facial paralysis: A scoping review","authors":"Shaun Edalati BS, Barak Spector BA, Richa Nathan BA, Vikram Vasan BS, Joshua Rosenberg MD, Mingyang L. Gray MD","doi":"10.1016/j.amjoto.2024.104562","DOIUrl":"10.1016/j.amjoto.2024.104562","url":null,"abstract":"<div><h3>Objectives</h3><div>In this study, we explore the use of extended reality (XR) therapy, which includes augmented (AR), virtual (VR), and mixed reality (MR), in patients experiencing symptoms of facial paralysis.</div></div><div><h3>Data sources</h3><div>Pubmed, Scopus, Embase.</div></div><div><h3>Methods</h3><div>A scoping review across PubMed, Scopus, Embase was performed following PRISMA-ScR systematic review guidelines with the use of Covidence.</div></div><div><h3>Results</h3><div>160 articles were identified and 7 articles, spanning from 2015 to 2023, ultimately met the criteria for this review. The articles reviewed highlight various XR applications and grading systems designed to enhance facial muscle strength, symmetry, and emotional well-being in Bell's palsy patients. Notable programs include FaraPy, FACE2FACE®App, eFace App, Canfeld, RealSense, GY MEDIC, and FaceRehab. These programs exhibit significant potential as effective rehabilitation and assessment tools in facial paralysis patients.</div></div><div><h3>Conclusion</h3><div>The use of extended reality (XR) technologies, along with 3D and 4D imaging, represents a major advancement in the field of facial paralysis therapy. These innovations offer exciting possibilities for enhancing patient care and optimizing outcomes for patients experiencing facial paralysis and muscle deficits. As these technologies start to be integrated into clinical contexts, further research and validation is required to ensure their efficacy and utilization.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 2","pages":"Article 104562"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.amjoto.2024.104557
Luigi Angelo Vaira , Giacomo De Riu , Carlos Miguel Chiesa-Estomba , Antonino Maniaci , Miguel Mayo-Yáñez , Alberto Maria Saibene , Jerome R. Lechien
{"title":"How we ask matters: Ensuring accurate responses from AI in patient counseling","authors":"Luigi Angelo Vaira , Giacomo De Riu , Carlos Miguel Chiesa-Estomba , Antonino Maniaci , Miguel Mayo-Yáñez , Alberto Maria Saibene , Jerome R. Lechien","doi":"10.1016/j.amjoto.2024.104557","DOIUrl":"10.1016/j.amjoto.2024.104557","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 2","pages":"Article 104557"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.amjoto.2024.104561
Zainab Balogun , Sophia Dang , Rahilla Tarfa , Nadine Haykal , Amber Shaffer , Jennifer McCoy , David Chi
Purpose
To examine the audiometric outcomes of a footplate shoe (FPS) in total ossicular chain reconstruction prostheses (TORP) compared to TORP without shoe.
Materials and methods
Retrospective cohort study of patients who underwent TORP from 2010 to 2021 at a tertiary children's hospital. Patients without audiograms or unknown FPS status were excluded. Demographics, TORP indication, pure tone average (PTA) thresholds, and TORP revisions/replacements were recorded. Characteristics of patients with and without FPS were compared using exact logistic regression, t-test, Wilcoxon rank-sum, and log-rank tests.
Results
Of 76 patients, 27 (36 %) were female, and median age was 9.9 years (range 2.5–22.0 years). FPS was present in 12 (16 %) cases. Mean pre-operative PTA was 49.4 dB (SD: 15.1 dB) (no FPS) and 47.1 dB (SD: 9.3 dB) (with FPS) (P = 0.62). The first post-operative median PTA (median 3 months following surgery) was 36.3 dB (range 13.8–101.3 dB) (no FPS) and 31.6 dB (range 16.9–56.3 dB) in FPS group (P = 0.24). At the second post-operative visit (median 30.5 months following first audiogram), PTA increased to 45.6 dB (SD: 18.1 dB) (no FPS) compared to the first postoperative visit (P = 0.001). However, PTA was stable in the FPS group at the second postoperative visit (mean 35.6 dB, SD: 22.0 dB) compared to the first postoperative visit (P = 0.50).
Conclusions
Surgical intervention, regardless of FPS status, demonstrates significant improvement in audiometric outcomes at the first post-operative visit. At the second post-operative, there were no differences in audiometric outcomes among the FPS group, while the no FPS group had worse audiometric outcomes.
{"title":"Hearing following total ossicular chain reconstruction prosthesis with and without footplate shoe prosthesis","authors":"Zainab Balogun , Sophia Dang , Rahilla Tarfa , Nadine Haykal , Amber Shaffer , Jennifer McCoy , David Chi","doi":"10.1016/j.amjoto.2024.104561","DOIUrl":"10.1016/j.amjoto.2024.104561","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the audiometric outcomes of a footplate shoe (FPS) in total ossicular chain reconstruction prostheses (TORP) compared to TORP without shoe.</div></div><div><h3>Materials and methods</h3><div>Retrospective cohort study of patients who underwent TORP from 2010 to 2021 at a tertiary children's hospital. Patients without audiograms or unknown FPS status were excluded. Demographics, TORP indication, pure tone average (PTA) thresholds, and TORP revisions/replacements were recorded. Characteristics of patients with and without FPS were compared using exact logistic regression, <em>t</em>-test, Wilcoxon rank-sum, and log-rank tests.</div></div><div><h3>Results</h3><div>Of 76 patients, 27 (36 %) were female, and median age was 9.9 years (range 2.5–22.0 years). FPS was present in 12 (16 %) cases. Mean pre-operative PTA was 49.4 dB (SD: 15.1 dB) (no FPS) and 47.1 dB (SD: 9.3 dB) (with FPS) (<em>P</em> = 0.62). The first post-operative median PTA (median 3 months following surgery) was 36.3 dB (range 13.8–101.3 dB) (no FPS) and 31.6 dB (range 16.9–56.3 dB) in FPS group (<em>P</em> = 0.24). At the second post-operative visit (median 30.5 months following first audiogram), PTA <u>increased</u> to 45.6 dB (SD: 18.1 dB) (no FPS) compared to the first postoperative visit (<em>P</em> = 0.001). However, PTA was stable in the FPS group at the second postoperative visit (mean 35.6 dB, SD: 22.0 dB) compared to the first postoperative visit (<em>P</em> = 0.50).</div></div><div><h3>Conclusions</h3><div>Surgical intervention, regardless of FPS status, demonstrates significant improvement in audiometric outcomes at the first post-operative visit. At the second post-operative, there were no differences in audiometric outcomes among the FPS group, while the no FPS group had worse audiometric outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 2","pages":"Article 104561"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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