To investigate postural stability in patients with vestibular migraine (VM) and probable vestibular migraine (PVM) in the absence of acute vestibular symptoms.
Methods
We retrospectively reviewed the medical records at our balance disorder clinic. The 30 consecutive VM patients and 25 consecutive PVM patients enrolled in this study all underwent foam posturography. 194 healthy control subjects with no history of dizziness or balance dysfunction was also enrolled. Multiple regression analyses were performed to see whether subjects' age, sex, or diagnosis (VM, PVM and control) were associated with the posturographic findings. Dependent variables were the mean velocity of the center of pressure movement (velocity) and the area enclosed by the center of pressure movement (area) in Fixed/Open, Fixed/Closed, Foam/Open and Foam/Closed conditions, the Romberg's ratio in Velocity/Fixed, Velocity/Foam, Area/Fixed and Area/Foam conditions, and the foam ratio in Velocity/Open, Velocity/Closed, Area/Open and Area/Closed. Independent variables were sex (male, female), age, and diagnosis (VM, PVM and control).
Results
VM and PVM patients showed significantly increased velocity and area compared to healthy controls with and without foam rubber. VM and PVM patients showed significantly lower foam ratios compared to healthy controls in velocity and area, both with open and closed eyes. On the other hand, there were no significant differences in velocity or area, Romberg's ratio or foam ratio between VM patients and PVM patients in any conditions.
Conclusions
Both VM and PVM patients had more postural instability than healthy controls. There were no differences in postural stability between VM and PVM patients.
{"title":"Postural stability in patients with vestibular migraine and probable vestibular migraine in the absence of acute vestibular symptoms","authors":"Chisato Fujimoto , Misaki Koyama , Takuya Kawahara , Kento Koda , Kentaro Ichijo , Mineko Oka , Teru Kamogashira , Makoto Kinoshita , Shinichi Demura , Kenji Kondo","doi":"10.1016/j.amjoto.2024.104551","DOIUrl":"10.1016/j.amjoto.2024.104551","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate postural stability in patients with vestibular migraine (VM) and probable vestibular migraine (PVM) in the absence of acute vestibular symptoms.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the medical records at our balance disorder clinic. The 30 consecutive VM patients and 25 consecutive PVM patients enrolled in this study all underwent foam posturography. 194 healthy control subjects with no history of dizziness or balance dysfunction was also enrolled. Multiple regression analyses were performed to see whether subjects' age, sex, or diagnosis (VM, PVM and control) were associated with the posturographic findings. Dependent variables were the mean velocity of the center of pressure movement (velocity) and the area enclosed by the center of pressure movement (area) in Fixed/Open, Fixed/Closed, Foam/Open and Foam/Closed conditions, the Romberg's ratio in Velocity/Fixed, Velocity/Foam, Area/Fixed and Area/Foam conditions, and the foam ratio in Velocity/Open, Velocity/Closed, Area/Open and Area/Closed. Independent variables were sex (male, female), age, and diagnosis (VM, PVM and control).</div></div><div><h3>Results</h3><div>VM and PVM patients showed significantly increased velocity and area compared to healthy controls with and without foam rubber. VM and PVM patients showed significantly lower foam ratios compared to healthy controls in velocity and area, both with open and closed eyes. On the other hand, there were no significant differences in velocity or area, Romberg's ratio or foam ratio between VM patients and PVM patients in any conditions.</div></div><div><h3>Conclusions</h3><div>Both VM and PVM patients had more postural instability than healthy controls. There were no differences in postural stability between VM and PVM patients.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104551"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142778771","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 : 2025-01-01DOI: 10.1016/j.amjoto.2024.104531
Ying Hu , Dan Bing , Aiguo Liu , Shun Zhang , Juan Li , Wenzhen Zhu
Purpose
To examine alterations in Blood Oxygen Level-Dependent (BOLD) resting-state functional magnetic resonance imaging (rs-fMRI) signals, utilizing regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF) metrics, within activated brain regions. Additionally, this study aims to explore the relationship between these neural changes and clinical characteristics, as well as emotional states, in patients diagnosed with unilateral Meniere's disease (MD).
Method
The study included 24 patients diagnosed with left Meniere's disease (L-MD), 25 patients diagnosed with right Meniere's disease (R-MD), and 23 healthy control subjects. Resting-state blood‑oxygen-level-dependent functional magnetic resonance imaging (rest-BOLD-fMRI) data were preprocessed. A two-sample t-test was employed to compare the regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF) between the patient groups and the control group. Brain regions exhibiting significant differences were further analyzed for correlations with disease duration, vertigo severity, vertigo duration, hearing loss grade, and levels of anxiety and depression.
Results
In patients with L-MD, fALFF values were significantly decreased in the right cerebellar hemisphere, middle occipital gyrus, among other regions. In patients with right-sided Ménière's disease (R-MD), fractional amplitude of low-frequency fluctuation (fALFF) values were elevated in the right middle inferior temporal gyrus and fusiform gyrus. Regional homogeneity (ReHo) values exhibited both increases and decreases in the temporal gyrus, parahippocampal gyrus, occipital gyrus, superior marginal gyrus, anterior central gyrus, and fusiform gyrus. In studies examining relational aspects, the parahippocampal gyrus, inferior temporal gyrus, middle occipital gyrus, superior middle occipital gyrus, superior marginal gyrus, and occipital gyrus demonstrated positive or negative correlations with clinical characteristics and emotional states.
Conclusions
Patients with unilateral Meniere's disease (MD) exhibited both increased and decreased activation in various brain regions when compared to control subjects. A correlation was identified between these neural activation patterns and clinical characteristics, as well as emotional state, which holds significant implications for clinical treatment, prognosis, and rehabilitation strategies for MD patients.
{"title":"A preliminary study of fMRI and the relationship with depression and anxiety in Meniere's patients","authors":"Ying Hu , Dan Bing , Aiguo Liu , Shun Zhang , Juan Li , Wenzhen Zhu","doi":"10.1016/j.amjoto.2024.104531","DOIUrl":"10.1016/j.amjoto.2024.104531","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine alterations in Blood Oxygen Level-Dependent (BOLD) resting-state functional magnetic resonance imaging (rs-fMRI) signals, utilizing regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF) metrics, within activated brain regions. Additionally, this study aims to explore the relationship between these neural changes and clinical characteristics, as well as emotional states, in patients diagnosed with unilateral Meniere's disease (MD).</div></div><div><h3>Method</h3><div>The study included 24 patients diagnosed with left Meniere's disease (L-MD), 25 patients diagnosed with right Meniere's disease (R-MD), and 23 healthy control subjects. Resting-state blood‑oxygen-level-dependent functional magnetic resonance imaging (rest-BOLD-fMRI) data were preprocessed. A two-sample <em>t</em>-test was employed to compare the regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF) between the patient groups and the control group. Brain regions exhibiting significant differences were further analyzed for correlations with disease duration, vertigo severity, vertigo duration, hearing loss grade, and levels of anxiety and depression.</div></div><div><h3>Results</h3><div>In patients with L-MD, fALFF values were significantly decreased in the right cerebellar hemisphere, middle occipital gyrus, among other regions. In patients with right-sided Ménière's disease (R-MD), fractional amplitude of low-frequency fluctuation (fALFF) values were elevated in the right middle inferior temporal gyrus and fusiform gyrus. Regional homogeneity (ReHo) values exhibited both increases and decreases in the temporal gyrus, parahippocampal gyrus, occipital gyrus, superior marginal gyrus, anterior central gyrus, and fusiform gyrus. In studies examining relational aspects, the parahippocampal gyrus, inferior temporal gyrus, middle occipital gyrus, superior middle occipital gyrus, superior marginal gyrus, and occipital gyrus demonstrated positive or negative correlations with clinical characteristics and emotional states.</div></div><div><h3>Conclusions</h3><div>Patients with unilateral Meniere's disease (MD) exhibited both increased and decreased activation in various brain regions when compared to control subjects. A correlation was identified between these neural activation patterns and clinical characteristics, as well as emotional state, which holds significant implications for clinical treatment, prognosis, and rehabilitation strategies for MD patients.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104531"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816888","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 : 2025-01-01DOI: 10.1016/j.amjoto.2024.104578
Courtney B. Shires , Merry E. Sebelik
<div><h3>Background</h3><div>Due to its complexity and multimodality treatment needs, traditional delivery of head and neck cancer care often occurs in a multidisciplinary cancer center, frequently in a university-based program in an urban setting. Fellowship training opportunities for subspecialty-focused head and neck surgeons have increased over recent years. There is a persistent concern that the number of newly minted Head & Neck Surgeons graduating each year outpaces the number of university-based employment opportunities, and that the workforce does not match the job opportunities. Recent publications examine this potential mismatch to better understand career choices, with a 2021 survey revealing that nearly 90 % of fellowship graduates were employed by a university or academic institution and only 10 % reported being in “private practice”. However, it should not be an automatic assumption that academic practice is somehow superior to private practice. Moreover, not every patient can access university-based care, creating a societal mismatch between disease incidence, resources, and access to high quality care. The well-trained Head & Neck Surgeon may be able to deliver excellent care in a satisfying practice setting without an academic affiliation.</div></div><div><h3>Methods</h3><div>Two Head & Neck Surgeons who have practiced in both Academic and Community-based (“private”) subspecialty settings offer practical and actionable tips to provide high level evidence-based head and neck surgical care without the trappings of a university, and with a focus on patient-centered care as well as career satisfaction. Further, since graduates of comprehensive otolaryngology training programs receive a robust amount of head and neck surgery training in residency, understanding these practical tips will potentially assist the Comprehensive Otolaryngologist in private practice to expand head and neck services within their practice.</div></div><div><h3>Objectives</h3><div>1) Review recently published survey-based reports of practice patterns and career satisfaction of recent HNS fellowship graduates, recognizing self-reported rates of practice settings, academic versus non-university-based (“private practice”). 2) Analyze and report practice structure of HNS graduates over the years 2015 to 2021 to determine rates of practice structure change from academic to private or vice versa, using Public Use Files combined with Google search. 3) Outline tips and pearls for a successful Head & Neck Surgery practice in a non-university-based setting, with 11 practical and actionable items that will allow high level subspecialty care without the traditional attributes of academic employment.</div></div><div><h3>Conclusions</h3><div>Graduates of head & neck surgery fellowships in recent years may perceive a paucity of academic job opportunities. This article reviews practice patterns of recent graduates, and presents practical tips to achieve a s
背景：由于其复杂性和多模式的治疗需求，传统的头颈癌护理通常在多学科癌症中心进行，通常在城市环境中的大学项目中进行。近年来，以专科为重点的头颈外科医生的奖学金培训机会有所增加。人们一直担心，每年新毕业的头颈外科医生的数量超过了大学就业机会的数量，而且劳动力与就业机会不匹配。最近的出版物研究了这种潜在的不匹配，以更好地理解职业选择。2021年的一项调查显示，近90%的奖学金毕业生受雇于大学或学术机构，只有10%的人自称在“私人执业”。然而，不应该自动假设学术实践在某种程度上优于私人实践。此外，并不是每个病人都能获得基于大学的护理，这就造成了疾病发病率、资源和获得高质量护理之间的社会不匹配。训练有素的头颈外科医生可以在没有学术关系的情况下，在令人满意的实践环境中提供出色的护理。方法：两位在学术和社区（“私人”）亚专业环境中实践过的头颈外科医生提供了实用和可操作的建议，以提供高水平的循证头颈外科护理，而不是大学的陷阱，并专注于以患者为中心的护理以及职业满意度。此外，由于综合耳鼻喉科培训项目的毕业生在住院医师中接受了大量的头颈外科培训，了解这些实用技巧将有可能帮助私人执业的综合耳鼻喉科医生在他们的实践中扩大头颈服务。目标：1)回顾最近发表的基于调查的关于最近HNS奖学金毕业生的实践模式和职业满意度的报告，认识到自我报告的实践环境率，学术与非大学（“私人实践”）。2)利用Public Use Files结合谷歌搜索，分析报告2015 - 2021年HNS毕业生的实践结构，确定从学术到私人或反之的实践结构变化率。3)概述在非大学背景下成功的头颈外科实践的技巧和要点，包括11个实用和可操作的项目，这些项目将允许高水平的亚专科护理，而不需要传统的学术就业属性。结论：近年来获得头颈外科奖学金的毕业生可能会感到学术工作机会的缺乏。本文回顾了近期毕业生的实践模式，并提出了在私人执业环境中实现令人满意的头颈外科职业生涯的实用技巧。
{"title":"Head & neck surgical oncology: Success in private practice","authors":"Courtney B. Shires , Merry E. Sebelik","doi":"10.1016/j.amjoto.2024.104578","DOIUrl":"10.1016/j.amjoto.2024.104578","url":null,"abstract":"<div><h3>Background</h3><div>Due to its complexity and multimodality treatment needs, traditional delivery of head and neck cancer care often occurs in a multidisciplinary cancer center, frequently in a university-based program in an urban setting. Fellowship training opportunities for subspecialty-focused head and neck surgeons have increased over recent years. There is a persistent concern that the number of newly minted Head & Neck Surgeons graduating each year outpaces the number of university-based employment opportunities, and that the workforce does not match the job opportunities. Recent publications examine this potential mismatch to better understand career choices, with a 2021 survey revealing that nearly 90 % of fellowship graduates were employed by a university or academic institution and only 10 % reported being in “private practice”. However, it should not be an automatic assumption that academic practice is somehow superior to private practice. Moreover, not every patient can access university-based care, creating a societal mismatch between disease incidence, resources, and access to high quality care. The well-trained Head & Neck Surgeon may be able to deliver excellent care in a satisfying practice setting without an academic affiliation.</div></div><div><h3>Methods</h3><div>Two Head & Neck Surgeons who have practiced in both Academic and Community-based (“private”) subspecialty settings offer practical and actionable tips to provide high level evidence-based head and neck surgical care without the trappings of a university, and with a focus on patient-centered care as well as career satisfaction. Further, since graduates of comprehensive otolaryngology training programs receive a robust amount of head and neck surgery training in residency, understanding these practical tips will potentially assist the Comprehensive Otolaryngologist in private practice to expand head and neck services within their practice.</div></div><div><h3>Objectives</h3><div>1) Review recently published survey-based reports of practice patterns and career satisfaction of recent HNS fellowship graduates, recognizing self-reported rates of practice settings, academic versus non-university-based (“private practice”). 2) Analyze and report practice structure of HNS graduates over the years 2015 to 2021 to determine rates of practice structure change from academic to private or vice versa, using Public Use Files combined with Google search. 3) Outline tips and pearls for a successful Head & Neck Surgery practice in a non-university-based setting, with 11 practical and actionable items that will allow high level subspecialty care without the traditional attributes of academic employment.</div></div><div><h3>Conclusions</h3><div>Graduates of head & neck surgery fellowships in recent years may perceive a paucity of academic job opportunities. This article reviews practice patterns of recent graduates, and presents practical tips to achieve a s","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104578"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891421","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 : 2025-01-01DOI: 10.1016/j.amjoto.2024.104564
Deepthi S. Akella , Jeremy Walsh , Maya Raghavan , Alexandra F. Corbin , Julia E. Barkell , Nicole M. Favre , Michele M. Carr
Objective
Trampolines are popular among children, but trampoline injuries constitute a large number of emergency department visits. The purpose of this study was to determine how often neck injuries occur among children with trampoline-related injuries and to identify the mechanism of injury.
Methods
We analyzed the National Electronic Injury Surveillance System (NEISS) database to characterize patient demographics, injury types, injury subsite, and emergency department disposition status associated with trampoline related neck injuries between 2012 and 2021 in the United States. We utilized NEISS code 89 (neck) and code 1233 (trampoline) for our query along and identified patients between 0 and 19 years.
Results
Of the 33,929 trampoline injuries, 1436 injuries involved the neck (4.2 %). The overall mean age was 8.0 ± 4.1 years and there were 17,728 (52 %) males and 16,201 (48 %) females in the group. Mean age of children with neck injuries was higher (9.2 ± 3.6 years) compared to children with other injuries (8.0 ± 4.1 years, P < .001). Males had a higher proportion of neck injuries compared to all injuries 800 (56 %) versus females 636 (44 %, P = .007). The most common neck injury was neck strain/sprain with 993 (69 % of neck injuries). The next most common diagnoses included neck contusions at 34 (2 %) and fractures at 20 (1 %). Children with neck injuries were more likely to be discharged prior to admission compared to other trampoline-related injuries (96 % versus 93 %, P < .001).
Conclusions
Neck strains/sprains are the most common type of pediatric trampoline-related neck injuries. Older children and males are more likely to have neck injuries while using the trampoline.
{"title":"Pediatric neck injuries associated with trampoline use","authors":"Deepthi S. Akella , Jeremy Walsh , Maya Raghavan , Alexandra F. Corbin , Julia E. Barkell , Nicole M. Favre , Michele M. Carr","doi":"10.1016/j.amjoto.2024.104564","DOIUrl":"10.1016/j.amjoto.2024.104564","url":null,"abstract":"<div><h3>Objective</h3><div>Trampolines are popular among children, but trampoline injuries constitute a large number of emergency department visits. The purpose of this study was to determine how often neck injuries occur among children with trampoline-related injuries and to identify the mechanism of injury.</div></div><div><h3>Methods</h3><div>We analyzed the National Electronic Injury Surveillance System (NEISS) database to characterize patient demographics, injury types, injury subsite, and emergency department disposition status associated with trampoline related neck injuries between 2012 and 2021 in the United States. We utilized NEISS code 89 (neck) and code 1233 (trampoline) for our query along and identified patients between 0 and 19 years.</div></div><div><h3>Results</h3><div>Of the 33,929 trampoline injuries, 1436 injuries involved the neck (4.2 %). The overall mean age was 8.0 ± 4.1 years and there were 17,728 (52 %) males and 16,201 (48 %) females in the group. Mean age of children with neck injuries was higher (9.2 ± 3.6 years) compared to children with other injuries (8.0 ± 4.1 years, <em>P</em> < .001). Males had a higher proportion of neck injuries compared to all injuries 800 (56 %) versus females 636 (44 %, <em>P</em> = .007). The most common neck injury was neck strain/sprain with 993 (69 % of neck injuries). The next most common diagnoses included neck contusions at 34 (2 %) and fractures at 20 (1 %). Children with neck injuries were more likely to be discharged prior to admission compared to other trampoline-related injuries (96 % versus 93 %, <em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>Neck strains/sprains are the most common type of pediatric trampoline-related neck injuries. Older children and males are more likely to have neck injuries while using the trampoline.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104564"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871088","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 : 2025-01-01DOI: 10.1016/j.amjoto.2024.104548
Craig Hanna , David Danis III , Rotem Kimia , Heather Merkouris , Peter Steinwald , Miriam O'Leary , Jeremiah Tracy
Objective
This retrospective cohort study aims to compare donor site morbidity of three commonly used upper extremity flaps used in head and neck reconstructive surgery: scapular tip free flap (STFF), radial forearm free flap (RFFF), and pectoralis major pedicled flap (PMPF).
Methods
The billing database of an urban, academic, tertiary otolaryngology practice was queried to identify patients who underwent STFF, RFFF, and PMPF from 2020 to 2023. The primary outcome was identification of donor site pain and need for physical therapy (PT) referral after undergoing reconstruction.
Results
Seventy-three patients (44M:29F) underwent surgery that utilized upper extremity free or pedicled flaps. Patients undergoing free tissue transfer (FTT) were 5.455 times more likely to require PT referral compared to patients undergoing pedicled tissue transfer (PTT). Patients undergoing FTT were 3.417 times more likely to report donor site pain compared to patients undergoing PTT. There were no differences in post-operative PT referrals or post-operative donor site pain when comparing STFF or RFFF groups. Importantly, RFFF were primarily all fasciocutaneous flaps (33/35).
Conclusions
These findings have important implications when counselling patients regarding reconstructive options for complex head and neck surgery defects.
{"title":"Donor site morbidity of upper extremity flaps in head and neck reconstruction","authors":"Craig Hanna , David Danis III , Rotem Kimia , Heather Merkouris , Peter Steinwald , Miriam O'Leary , Jeremiah Tracy","doi":"10.1016/j.amjoto.2024.104548","DOIUrl":"10.1016/j.amjoto.2024.104548","url":null,"abstract":"<div><h3>Objective</h3><div>This retrospective cohort study aims to compare donor site morbidity of three commonly used upper extremity flaps used in head and neck reconstructive surgery: scapular tip free flap (STFF), radial forearm free flap (RFFF), and pectoralis major pedicled flap (PMPF).</div></div><div><h3>Methods</h3><div>The billing database of an urban, academic, tertiary otolaryngology practice was queried to identify patients who underwent STFF, RFFF, and PMPF from 2020 to 2023. The primary outcome was identification of donor site pain and need for physical therapy (PT) referral after undergoing reconstruction.</div></div><div><h3>Results</h3><div>Seventy-three patients (44M:29F) underwent surgery that utilized upper extremity free or pedicled flaps. Patients undergoing free tissue transfer (FTT) were 5.455 times more likely to require PT referral compared to patients undergoing pedicled tissue transfer (PTT). Patients undergoing FTT were 3.417 times more likely to report donor site pain compared to patients undergoing PTT. There were no differences in post-operative PT referrals or post-operative donor site pain when comparing STFF or RFFF groups. Importantly, RFFF were primarily all fasciocutaneous flaps (33/35).</div></div><div><h3>Conclusions</h3><div>These findings have important implications when counselling patients regarding reconstructive options for complex head and neck surgery defects.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104548"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891420","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 : 2025-01-01DOI: 10.1016/j.amjoto.2024.104566
Meghna Joseph , Mrinal Murali Krishna , Ancy Jenil Franco , Laura Jekov , Renan Yuji Ura Sudo , Thamiris Dias Delfino Cabral
Introduction
Intranasal mometasone and oral montelukast have been found to be effective for adenoid hypertrophy in children. We aimed to compare the efficacy of combination therapy of mometasone and montelukast versus mometasone alone for adenoid hypertrophy in children.
Methods
Following PRISMA guidelines, we systematically searched PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov databases for randomized controlled trials (RCTs) comparing combination therapy of mometasone and montelukast with mometasone alone for adenoid hypertrophy in children. The outcomes of interest were rhinorrhea, snoring, mouth breathing, and adenoid/nasopharynx ratio. Data were pooled using a random effects model to generate mean differences (MD).
Results
3 RCTs comprising a total of 207 patients were included; (combination therapy n = 104 (50.2 %). Rhinorrhea (MD -1.47; 95 % CI -1.85 to −1.09; p < 0.01; I2 = 0 %), snoring (MD -1.33; 95 % CI -1.65 to −1.00; p < 0.01; I2 = 0 %), and mouth breathing (MD -1.06; 95 % CI -1.40 to −0.71; p < 0.01; I2 = 0 %) were significantly lower in patients treated with combination therapy. No difference was observed in the adenoid/nasopharynx ratio between the groups. However, analysis excluding the study with a high risk of bias showed a significant reduction in the adenoid/nasopharynx ratio (MD −10.73; 95 % CI −13.56 to −7.90; p < 0.01; I2 = 0 %) in the combination therapy group. During the 3-month follow-up period after cessation of treatment, adenoid/nasopharynx ratio, rhinorrhea, snoring, and mouth breathing were significantly lower in the combination therapy group.
Conclusion
In children with adenoid hypertrophy, combination therapy reduced rhinorrhea, snoring, mouth breathing, and adenoid/nasopharynx ratio at the end of the treatment period and 3 months after treatment cessation.
鼻内莫米松和口服孟鲁司特已被发现对儿童腺样体肥大有效。我们的目的是比较莫米松和孟鲁司特联合治疗与莫米松单独治疗儿童腺样体肥大的疗效。方法：遵循PRISMA指南，我们系统地检索PubMed、Embase、Cochrane CENTRAL和ClinicalTrials.gov数据库，比较莫米松和孟鲁司特联合治疗与莫米松单独治疗儿童腺样体肥大的随机对照试验（rct）。关注的结局是鼻漏、打鼾、口呼吸和腺样体/鼻咽比率。使用随机效应模型合并数据以产生平均差异（MD）。结果：共纳入3项rct，共207例患者；（联合治疗104例，占50.2%）。鼻漏(MD -1.47；95% CI -1.85 ~ -1.09；p 2 = 0%)、打鼾(MD -1.33；95% CI -1.65 ~ -1.00；p 2 = 0%)，口腔呼吸(MD -1.06；95% CI -1.40 ~ -0.71；P 2 = 0 %)明显低于联合治疗组。两组间腺样体/鼻咽部比值无差异。然而，排除高偏倚风险研究的分析显示，腺样体/鼻咽比显著降低(MD -10.73；95% CI -13.56 -7.90；P 2 = 0 %)。停药后随访3个月，联合治疗组腺样体/鼻咽比、鼻漏、打鼾、口腔呼吸均明显降低。结论：在腺样体肥大的儿童中，联合治疗在治疗期结束和停止治疗后3个月减少了鼻出血、打鼾、口腔呼吸和腺样体/鼻咽比。
{"title":"Efficacy of combination therapy with mometasone and montelukast versus mometasone alone in treatment of adenoid hypertrophy in children: A systematic review and meta-analysis","authors":"Meghna Joseph , Mrinal Murali Krishna , Ancy Jenil Franco , Laura Jekov , Renan Yuji Ura Sudo , Thamiris Dias Delfino Cabral","doi":"10.1016/j.amjoto.2024.104566","DOIUrl":"10.1016/j.amjoto.2024.104566","url":null,"abstract":"<div><h3>Introduction</h3><div>Intranasal mometasone and oral montelukast have been found to be effective for adenoid hypertrophy in children. We aimed to compare the efficacy of combination therapy of mometasone and montelukast versus mometasone alone for adenoid hypertrophy in children.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, we systematically searched PubMed, Embase, Cochrane CENTRAL, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> databases for randomized controlled trials (RCTs) comparing combination therapy of mometasone and montelukast with mometasone alone for adenoid hypertrophy in children. The outcomes of interest were rhinorrhea, snoring, mouth breathing, and adenoid/nasopharynx ratio. Data were pooled using a random effects model to generate mean differences (MD).</div></div><div><h3>Results</h3><div>3 RCTs comprising a total of 207 patients were included; (combination therapy <em>n</em> = 104 (50.2 %). Rhinorrhea (MD -1.47; 95 % CI -1.85 to −1.09; <em>p</em> < 0.01; I<sup>2</sup> = 0 %), snoring (MD -1.33; 95 % CI -1.65 to −1.00; p < 0.01; I<sup>2</sup> = 0 %), and mouth breathing (MD -1.06; 95 % CI -1.40 to −0.71; p < 0.01; I<sup>2</sup> = 0 %) were significantly lower in patients treated with combination therapy. No difference was observed in the adenoid/nasopharynx ratio between the groups. However, analysis excluding the study with a high risk of bias showed a significant reduction in the adenoid/nasopharynx ratio (MD −10.73; 95 % CI −13.56 to −7.90; <em>p</em> < 0.01; I<sup>2</sup> = 0 %) in the combination therapy group. During the 3-month follow-up period after cessation of treatment, adenoid/nasopharynx ratio, rhinorrhea, snoring, and mouth breathing were significantly lower in the combination therapy group.</div></div><div><h3>Conclusion</h3><div>In children with adenoid hypertrophy, combination therapy reduced rhinorrhea, snoring, mouth breathing, and adenoid/nasopharynx ratio at the end of the treatment period and 3 months after treatment cessation.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104566"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876023","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 : 2025-01-01DOI: 10.1016/j.amjoto.2024.104585
James P. McDonald , Paul J. Farnsworth , Norbert G. Campeau , Shuai Leng , Matthew L. Carlson , John C. Benson , Ian T. Mark , John I. Lane
Purpose
To compare the performance of the photon-counting detector (PCD)-CT versus a state-of-the-art energy-integrating detector (EID)-CT to identify segments of the inferior tympanic canaliculus (Jacobsons nerve) and the mastoid canaliculus (Arnolds nerve).
Materials & methods
Patients were prospectively recruited to undergo temporal bone CT on both EID-CT (Siemens Somatom Force) and PCD-CT (Siemens NAEOTOM Alpha) scanners under an IRB-approved protocol. Three neuroradiologists reviewed cases by consensus comparing the ability to identify the proximal, mid, and distal segments of the inferior tympanic canaliculus/Jacobsons nerve and mastoid canaliculus/Arnolds nerve on each scanner using 5-point Likert scales (with 1 indicating EID is far superior to PCD, 3 indicating they are equivalent, and 5 indicating PCD is far superior to EID).
Results
Forty temporal bones were analyzed. Average Likert scores for the ability to evaluate the proximal, mid, and distal aspects of inferior tympanic canaliculus/Jacobsons nerve on the PCD compared to EID scanner were 4.5 (SD = 0.6), 4.2 (0.4), and 4.1 (0.3). The scores for the mastoid canaliculus/Arnolds nerve were 4.0 (0.4), 4.1 (0.4), and 4.0 (0.4). Overall, the PCD scanner performed better than EID for image quality (Median = 4.2, 95 % CI = [4.1, 5.0], p-value < 0.001).
Conclusion
PCD-CT provides superior visualization of the proximal, mid, and distal aspects of the inferior tympanic canaliculus/Jacobsons nerve and mastoid canaliculus/Arnolds nerve compared to EID-CT examinations. The improved visualization of these nerves could be important for characterization of subtle pathology involving these structures, such as tympanic paraganglioma or nodular perineural spread.
{"title":"Improved visualization of the inferior tympanic and mastoid canaliculi with photon counting detector CT","authors":"James P. McDonald , Paul J. Farnsworth , Norbert G. Campeau , Shuai Leng , Matthew L. Carlson , John C. Benson , Ian T. Mark , John I. Lane","doi":"10.1016/j.amjoto.2024.104585","DOIUrl":"10.1016/j.amjoto.2024.104585","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the performance of the photon-counting detector (PCD)-CT versus a state-of-the-art energy-integrating detector (EID)-CT to identify segments of the inferior tympanic canaliculus (Jacobsons nerve) and the mastoid canaliculus (Arnolds nerve).</div></div><div><h3>Materials & methods</h3><div>Patients were prospectively recruited to undergo temporal bone CT on both EID-CT (Siemens Somatom Force) and PCD-CT (Siemens NAEOTOM Alpha) scanners under an IRB-approved protocol. Three neuroradiologists reviewed cases by consensus comparing the ability to identify the proximal, mid, and distal segments of the inferior tympanic canaliculus/Jacobsons nerve and mastoid canaliculus/Arnolds nerve on each scanner using 5-point Likert scales (with 1 indicating EID is far superior to PCD, 3 indicating they are equivalent, and 5 indicating PCD is far superior to EID).</div></div><div><h3>Results</h3><div>Forty temporal bones were analyzed. Average Likert scores for the ability to evaluate the proximal, mid, and distal aspects of inferior tympanic canaliculus/Jacobsons nerve on the PCD compared to EID scanner were 4.5 (SD = 0.6), 4.2 (0.4), and 4.1 (0.3). The scores for the mastoid canaliculus/Arnolds nerve were 4.0 (0.4), 4.1 (0.4), and 4.0 (0.4). Overall, the PCD scanner performed better than EID for image quality (Median = 4.2, 95 % CI = [4.1, 5.0], <em>p</em>-value < 0.001).</div></div><div><h3>Conclusion</h3><div>PCD-CT provides superior visualization of the proximal, mid, and distal aspects of the inferior tympanic canaliculus/Jacobsons nerve and mastoid canaliculus/Arnolds nerve compared to EID-CT examinations. The improved visualization of these nerves could be important for characterization of subtle pathology involving these structures, such as tympanic paraganglioma or nodular perineural spread.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104585"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913725","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 : 2025-01-01DOI: 10.1016/j.amjoto.2024.104595
Ogechukwu S. Anwaegbu , Delayne M. Coleman , Janisah Amirah I. Saripada , Smiti Gandhi , Cody D. Luong , Michel M. Adeniran , Brian J. McKinnon
Objective
To evaluate the quality and engagement of rhinology-related educational videos shared by healthcare providers on Instagram.
Methods
The top 150 videos on Instagram for #SinusSurgeryEducation, #TurbinateReductionEducation, and #SeptoplastyEducation were selected. Videos were categorized by provider's specialty and analyzed for engagement metrics (likes, comments, shares, views), video duration, and hashtags. The Patient Education Materials Assessment Tool Audio/Visual (PEMAT-A/V) was used to assess the understandability and actionability of the medical educational videos.
Results
Sixty-three videos were analyzed: septoplasty education (26 videos), turbinate reduction education (17 videos), and sinus surgery education (20 videos). Of these, 88 % were classified as medical education content, while 12% focused on before-and-after surgery visualizations.
Among the educational content, 38 % were by otolaryngologists, 32 % by plastic surgeons, and 30 % by other providers such as anesthesiologists and chiropractors. Content created by plastic surgeons received higher engagement metrics compared to otolaryngologists. The average PEMAT-A/V scores were 75 % for understandability and 37 % for actionability.
Conclusion
Our analysis reveals that plastic surgeons and otolaryngologists are using social media for medical education, with content demonstrating moderate engagement and quality understandability. As social media continues to evolve as a source for disseminating health-related information, providers should strive to understand its mechanisms and impacts.
{"title":"Assessing the presence of rhinological surgery on social media: Factors influencing searches","authors":"Ogechukwu S. Anwaegbu , Delayne M. Coleman , Janisah Amirah I. Saripada , Smiti Gandhi , Cody D. Luong , Michel M. Adeniran , Brian J. McKinnon","doi":"10.1016/j.amjoto.2024.104595","DOIUrl":"10.1016/j.amjoto.2024.104595","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the quality and engagement of rhinology-related educational videos shared by healthcare providers on Instagram.</div></div><div><h3>Methods</h3><div>The top 150 videos on Instagram for <em>#SinusSurgeryEducation</em>, #<em>TurbinateReductionEducation</em>, and #<em>SeptoplastyEducation</em> were selected. Videos were categorized by provider's specialty and analyzed for engagement metrics (likes, comments, shares, views), video duration, and hashtags. The Patient Education Materials Assessment Tool Audio/Visual (PEMAT-A/V) was used to assess the understandability and actionability of the medical educational videos.</div></div><div><h3>Results</h3><div>Sixty-three videos were analyzed: septoplasty education (26 videos), turbinate reduction education (17 videos), and sinus surgery education (20 videos). Of these, 88 % were classified as medical education content, while 12% focused on before-and-after surgery visualizations.</div><div>Among the educational content, 38 % were by otolaryngologists, 32 % by plastic surgeons, and 30 % by other providers such as anesthesiologists and chiropractors. Content created by plastic surgeons received higher engagement metrics compared to otolaryngologists. The average PEMAT-A/V scores were 75 % for understandability and 37 % for actionability.</div></div><div><h3>Conclusion</h3><div>Our analysis reveals that plastic surgeons and otolaryngologists are using social media for medical education, with content demonstrating moderate engagement and quality understandability. As social media continues to evolve as a source for disseminating health-related information, providers should strive to understand its mechanisms and impacts.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104595"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942642","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 : 2025-01-01DOI: 10.1016/j.amjoto.2024.104587
Ali Alaqla , Meshal Alhasoun , Mohammed Asseery , Saud Altheyabi , Fathima Fazrina Farook , Hajar Albanyan , Mohammad T. Al-Kadi
Background
Odontogenic maxillary sinusitis (OMS) is recognized in literature, but diagnosing it is challenging due to its different and overlapping clinical presentations of it. Misdiagnosis can lead to persistent symptoms and clinical burden. Interestingly, recent guidelines from the American Academy of Otolaryngology-Head and Neck Surgery lack recommendations for dental evaluation in adult sinusitis cases.
Aim
To assess ENT physicians' knowledge and skills in diagnosing maxillary sinusitis of odontogenic origin. This study may emphasize the importance of raising awareness to help in proper diagnosis, timely referral, and efficient management of patients with maxillary sinusitis of odontogenic origin.
Methods
A cross-sectional analytical study on 210 ENT specialists in Riyadh, Saudi Arabia to evaluate their knowledge and ability in detecting OMS electronically.
Results
Our sample included a total of 30 (14.29%) residents, 108 (51.43%) specialists, and 72 (34.28%) consultants. In cases of unilateral maxillary sinusitis, 61.43% of all participants reported that a dental examination was unnecessary. The regression analysis showed a significant interaction effect between the number of sinusitis cases per week and being a specialist (p = 0.0370). Conversely, there was no significant interaction effect between sinusitis cases per week and being a consultant (p = 0.1408).
Conclusion
ENT physicians underestimated the odontogenic etiology for unilateral OMS significantly. This study highlights the importance of targeted education to improve OMS detection and treatment and, ultimately, patient outcomes.
{"title":"ENT specialists' knowledge and their skills in detecting maxillary sinusitis of odontogenic origin, a cross-sectional study","authors":"Ali Alaqla , Meshal Alhasoun , Mohammed Asseery , Saud Altheyabi , Fathima Fazrina Farook , Hajar Albanyan , Mohammad T. Al-Kadi","doi":"10.1016/j.amjoto.2024.104587","DOIUrl":"10.1016/j.amjoto.2024.104587","url":null,"abstract":"<div><h3>Background</h3><div>Odontogenic maxillary sinusitis (OMS) is recognized in literature, but diagnosing it is challenging due to its different and overlapping clinical presentations of it. Misdiagnosis can lead to persistent symptoms and clinical burden. Interestingly, recent guidelines from the American Academy of Otolaryngology-Head and Neck Surgery lack recommendations for dental evaluation in adult sinusitis cases.</div></div><div><h3>Aim</h3><div>To assess ENT physicians' knowledge and skills in diagnosing maxillary sinusitis of odontogenic origin. This study may emphasize the importance of raising awareness to help in proper diagnosis, timely referral, and efficient management of patients with maxillary sinusitis of odontogenic origin.</div></div><div><h3>Methods</h3><div>A cross-sectional analytical study on 210 ENT specialists in Riyadh, Saudi Arabia to evaluate their knowledge and ability in detecting OMS electronically.</div></div><div><h3>Results</h3><div>Our sample included a total of 30 (14.29%) residents, 108 (51.43%) specialists, and 72 (34.28%) consultants. In cases of unilateral maxillary sinusitis, 61.43% of all participants reported that a dental examination was unnecessary. The regression analysis showed a significant interaction effect between the number of sinusitis cases per week and being a specialist (<em>p</em> = 0.0370). Conversely, there was no significant interaction effect between sinusitis cases per week and being a consultant (<em>p</em> = 0.1408).</div></div><div><h3>Conclusion</h3><div>ENT physicians underestimated the odontogenic etiology for unilateral OMS significantly. This study highlights the importance of targeted education to improve OMS detection and treatment and, ultimately, patient outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104587"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942645","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 : 2025-01-01DOI: 10.1016/j.amjoto.2024.104597
Cosimo Galletti , Federico Sireci , Giovanna Stilo , Maria Antonietta Barbieri , Giuliano Messina , Riccardo Manzella , Daniele Portelli , Andrea Guglielmo Zappalà , Mariut Diana , Silvia Frangipane , Angelo Immordino , Francesco Lorusso , Francesco Dispensa , Francesco Ciodaro , Francesco Freni , Francesco Galletti , Salvatore Gallina , Ignazio La Mantia , Bruno Galletti
Background
Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by a type 2 pattern of inflammation. Mepolizumab was approved for the treatment of CRSwNP in 2021. However, there is a lack of real-life studies.
Aim
This work aimed to evaluate the effectiveness and safety profile of Mepolizumab during the first year of treatment in a real-life setting.
Methods
A multicentric observational cohort study was carried out. A total of 67 patients were enrolled in the Otorhinolaryngology Unit of the three University Hospitals and considered for Mepolizumab therapy. All recorder characteristics were age (at the first Mepolizumab application visit), sex, smoke habits, previous local and systemic corticosteroid therapy, history of endoscopic sinus surgery, number of previous endoscopic sinus surgery, concomitant asthma, history of an allergic condition, immunoglobulin E (IgE), allergy to nonsteroidal anti-inflammatory drugs (NSAIDs), Aspirin Exacerbated Respiratory Disease (AERD), other comorbidities associated, blood eosinophils, nasal polyp score, sinonasal outcome test 22 (SNOT 22), sniffin' stick test, the start date of Mepolizumab therapy and number of doses of Mepolizumab and eventually, Mepolizumab's adverse events related to administration. The Wilcoxon test for dependent samples was performed to compare variables. Statistical significance was assumed for p values < 0.05.
Results
A statistically significant reduction in SNOT-22 and NPS was shown in the 6th and 12th month compared to baseline values (p < 0.001 for both comparisons). A statistically significant increase value at the Sniffin' sticks test was shown in the 6th and 12th month compared to baseline values (p < 0.001 for both comparisons).
At the 12-month follow-up, according to EUFOREA indications, all patients were considered to remain in treatment with Mepolizumab and continued the treatment because of a reduced NPS, improved quality of life, and a reduced need for system corticosteroids.
Conclusions
This multi-centric real-life study supported the effectiveness of Mepolizumab in patients with severe uncontrolled CRSwNP in the improvement of quality of life, the severity of symptoms, polyp size reduction, and smell function. Our data also support the safety profile of monoclonal therapy with Mepolizumab.
{"title":"Mepolizumab in chronic rhinosinusitis with nasal polyps: Real life data in a multicentric Sicilian experience","authors":"Cosimo Galletti , Federico Sireci , Giovanna Stilo , Maria Antonietta Barbieri , Giuliano Messina , Riccardo Manzella , Daniele Portelli , Andrea Guglielmo Zappalà , Mariut Diana , Silvia Frangipane , Angelo Immordino , Francesco Lorusso , Francesco Dispensa , Francesco Ciodaro , Francesco Freni , Francesco Galletti , Salvatore Gallina , Ignazio La Mantia , Bruno Galletti","doi":"10.1016/j.amjoto.2024.104597","DOIUrl":"10.1016/j.amjoto.2024.104597","url":null,"abstract":"<div><h3>Background</h3><div>Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by a type 2 pattern of inflammation. Mepolizumab was approved for the treatment of CRSwNP in 2021. However, there is a lack of real-life studies.</div></div><div><h3>Aim</h3><div>This work aimed to evaluate the effectiveness and safety profile of Mepolizumab during the first year of treatment in a real-life setting.</div></div><div><h3>Methods</h3><div>A multicentric observational cohort study was carried out. A total of 67 patients were enrolled in the Otorhinolaryngology Unit of the three University Hospitals and considered for Mepolizumab therapy. All recorder characteristics were age (at the first Mepolizumab application visit), sex, smoke habits, previous local and systemic corticosteroid therapy, history of endoscopic sinus surgery, number of previous endoscopic sinus surgery, concomitant asthma, history of an allergic condition, immunoglobulin E (IgE), allergy to nonsteroidal anti-inflammatory drugs (NSAIDs), Aspirin Exacerbated Respiratory Disease (AERD), other comorbidities associated, blood eosinophils, nasal polyp score, sinonasal outcome test 22 (SNOT 22), sniffin' stick test, the start date of Mepolizumab therapy and number of doses of Mepolizumab and eventually, Mepolizumab's adverse events related to administration. The Wilcoxon test for dependent samples was performed to compare variables. Statistical significance was assumed for <em>p</em> values < 0.05.</div></div><div><h3>Results</h3><div>A statistically significant reduction in SNOT-22 and NPS was shown in the 6th and 12th month compared to baseline values (p < 0.001 for both comparisons). A statistically significant increase value at the Sniffin' sticks test was shown in the 6th and 12th month compared to baseline values (<em>p</em> < 0.001 for both comparisons).</div><div>At the 12-month follow-up, according to EUFOREA indications, all patients were considered to remain in treatment with Mepolizumab and continued the treatment because of a reduced NPS, improved quality of life, and a reduced need for system corticosteroids.</div></div><div><h3>Conclusions</h3><div>This multi-centric real-life study supported the effectiveness of Mepolizumab in patients with severe uncontrolled CRSwNP in the improvement of quality of life, the severity of symptoms, polyp size reduction, and smell function. Our data also support the safety profile of monoclonal therapy with Mepolizumab.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104597"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998353","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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