American Journal of Otolaryngology最新文献_第4页

Adenoid regrowth and obesity in a longitudinal pediatric cohort 纵向儿童队列中的腺样体再生和肥胖。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-12-01 DOI: 10.1016/j.amjoto.2025.104764

Liliana Arida-Moody , Daniel R.S. Habib , Emma H. Neal , Amy S. Whigham

Objective

This study aims to elucidate the association between pediatric obesity and revision adenoidectomy in a cohort with longitudinal care needs.

Methods

Data were collected via chart review from a tertiary pediatric hospital for patients who underwent adenoidectomy from January 2015 to January 2016 and had 2 years of post-operative follow-up. Demographic, surgical, and clinical data were analyzed using logistic and Cox regression models to identify factors affecting the likelihood and timing of revision adenoidectomy.

Results

Of 461 patients, 115 (24.9 %) were obese at primary intervention. Secondary intervention was performed for 136 patients (29.5 %), with a median interval of 29 months between procedures. In the logistic regression, predictors of revision included younger age at primary intervention (OR = 0.844, p = 0.002), adenoidectomy over adenotonsillectomy as the initial surgery (OR = 0.3, p < 0.001), higher BMI percentile (OR = 1.008, p = 0.048), and allergic rhinitis (OR = 1.722, p = 0.039). In the Cox regression, hazard was lower with adenotonsillectomy (HR = 0.358, p < 0.001), older age at initial surgery (HR = 0.858, p = 0.001), and GERD (HR = 0.595, p = 0.05), but higher with laryngomalacia/tracheomalacia (HR = 1.909, p = 0.034). BMI percentile was not associated with revision timing in the Cox model. Model concordance was 0.694.

Conclusion

Odds of revision adenoidectomy in this population are increased with higher BMI percentile, younger age at primary intervention, undergoing initial adenoidectomy rather than adenotonsillectomy, and various comorbidities, with differing time-dependent effects. These findings support the potential role of obesity-related inflammation in adenoid hypertrophy and individualized surgical decision-making in pediatric patients with sleep disordered breathing.

目的：本研究旨在阐明具有纵向护理需求的队列中儿童肥胖与翻修腺样体切除术之间的关系。方法：采用图表复习法收集某三级儿科医院2015年1月至2016年1月行腺样体切除术患者的资料，术后随访2年。使用logistic和Cox回归模型分析人口统计学、外科和临床数据，以确定影响翻修腺样体切除术可能性和时机的因素。结果：在461例患者中，115例（24.9%）在初次干预时为肥胖。136例患者（29.5%）接受了二次干预，中间间隔为29个月。在logistic回归中，修正的预测因素包括初次干预时年龄更小（OR = 0.844, p = 0.002），腺样体切除术优于腺扁桃体切除术作为初始手术（OR = 0.3, p）。结论：在该人群中，修正腺样体切除术的几率随着BMI百分比的升高、初次干预时年龄更小、首次接受腺样体切除术而非腺扁桃体切除术以及各种合共病的增加而增加，这些合共病具有不同的时间依赖性。这些发现支持肥胖相关炎症在儿童睡眠呼吸障碍患者腺样体肥大和个体化手术决策中的潜在作用。

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引用次数: 0

Adjunctive dual biologic therapy for persistent nasal symptoms in eosinophilic granulomatosis with polyangiitis (EGPA) 辅助双重生物治疗嗜酸性肉芽肿病合并多血管炎（EGPA）的持续性鼻症状。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-12-01 DOI: 10.1016/j.amjoto.2025.104761

Giulia Gramellini , Marco Borin , Matteo Lazzeroni , Alberto Giulio Dragonetti , Pasquale Capaccio , Niccolò Mevio , Jan Walter Volk Schroeder

Eosinophilic granulomatosis with polyangiitis (EGPA) is an eosinophilic vasculitis frequently involving both upper and lower airways, commonly associated with severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). Although anti-IL-5/IL-5R biologics such as mepolizumab and benralizumab are established therapies for maintaining systemic remission, a subset of patients continues to experience refractory sinonasal symptoms. We report two EGPA cases with well-controlled systemic disease under anti-IL-5/IL-5R therapy but persistent uncontrolled CRSwNP, who were treated with add-on dupilumab. Both patients demonstrated substantial improvement in sinonasal outcomes, as reflected by reductions in SNOT-22 and nasal polyp scores, alongside maintenance of systemic remission (BVAS = 0). These findings highlight the potential role of dual biologic therapy targeting distinct inflammatory pathways in selected EGPA patients with refractory CRSwNP. Careful patient selection and close multidisciplinary monitoring are essential to ensure safety and optimize efficacy. Further studies are warranted to confirm long-term effectiveness and safety profiles.

嗜酸性肉芽肿病合并多血管炎（EGPA）是一种嗜酸性血管炎，常累及上呼吸道和下呼吸道，通常与严重哮喘和慢性鼻窦炎合并鼻息肉（CRSwNP）相关。尽管抗il -5/IL-5R生物制剂（如mepolizumab和benralizumab）是维持全身缓解的既定治疗方法，但仍有一部分患者持续出现难治性鼻窦症状。我们报告了两例EGPA患者，在抗il -5/IL-5R治疗下，全身性疾病得到良好控制，但持续不受控制的CRSwNP，他们接受了附加的dupilumab治疗。两名患者鼻窦预后均有显著改善，SNOT-22和鼻息肉评分降低，同时维持全身缓解（BVAS = 0）。这些发现强调了针对不同炎症途径的双重生物治疗在选择性EGPA患者难治性CRSwNP中的潜在作用。谨慎的患者选择和密切的多学科监测对于确保安全性和优化疗效至关重要。有必要进一步研究以确认其长期有效性和安全性。

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引用次数: 0

Headache resolution following the middle fossa repair of superior semicircular canal dehiscence 上半规管裂孔中窝修复术后头痛的解决。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-11-30 DOI: 10.1016/j.amjoto.2025.104752

Layla Ali , Adam Ali , Samuel Salib , Niloufar S. Tehrani , Hong-Ho Yang , Khashayar Mozaffari , Quinton Gopen

Objective

To investigate predictors of headache resolution following surgical intervention for superior semicircular canal dehiscence (SSCD) syndrome.

Method

We conducted a retrospective chart review on 344 surgical repairs of SSCD via the middle cranial fossa (MCF) approach conducted at an institution. The primary outcome measure was the resolution of headaches after SSCD repair. Analyses explored the predictive potential of several comorbidities and lifestyle factors pre-operatively.

Results

Among a total of 344 repairs, 193 (56 %) reported headaches preoperatively. Among which, 114 (59 %) experienced headache resolution following surgery. Compared to patients without a history of general anxiety disorder (GAD), patients with GAD reported a 65 % lower odds of headache resolution following surgery (aOR 0.35, 95 % CI [0.14, 0.91]). Compared to patients without hypertension (HTN), patients with HTN were significantly more likely to experience headache resolution following surgery (aOR 4.65, [1.19, 18.22]).

Conclusion

A substantial portion of patients with headaches experienced resolution following SSCD repair (∼60 %). Patients with GAD were less likely to experience headache resolution following SSCD repair, whereas patients with HTN were more likely to experience headache resolution.

Level of Evidence: Level IV

目的：探讨手术治疗上半规管裂（SSCD）综合征后头痛缓解的预测因素。方法：我们对某机构344例经颅中窝（MCF）入路手术修复SSCD的病例进行回顾性分析。主要结局指标是SSCD修复后头痛的消退。分析探讨了术前几种合并症和生活方式因素的预测潜力。结果：在344例修复中，193例（56%）报告术前头痛。其中114例（59%）手术后头痛得到缓解。与没有广泛性焦虑症（GAD）病史的患者相比，GAD患者手术后头痛缓解的几率低65% （aOR 0.35, 95% CI[0.14, 0.91]）。与无高血压患者（HTN）相比，HTN患者术后头痛缓解的可能性显著增加（aOR 4.65,[1.19, 18.22]）。结论：相当一部分患者在SSCD修复后头痛得到缓解（约60%）。广泛性焦虑症患者在SSCD修复后头痛缓解的可能性较小，而HTN患者头痛缓解的可能性更大。证据等级：四级。

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引用次数: 0

Risk factors for tonsillar hypertrophy and post-transplant lymphoproliferative disorder 扁桃体肥大和移植后淋巴细胞增生性疾病的危险因素。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-11-30 DOI: 10.1016/j.amjoto.2025.104756

Ross Rosen , Jamil Hayden , Jenna Rock , Alexandra Welschmeyer , Chelsea Cleveland , Todd Otteson

Introduction

Post-transplant lymphoproliferative disorder (PTLD) is a rare complication of immunosuppression in solid organ transplant patients. Tonsillar hypertrophy commonly results from PTLD, and tonsillectomy is usually performed when PTLD is the suspected cause. Risk factors for PTLD-mediated tonsillar hypertrophy remain poorly defined. This study aimed to identify clinical and therapeutic factors associated with tonsillar hypertrophy following PTLD diagnosis.

Methods

We conducted a retrospective cohort study using the TriNetX Database. Pediatric solid organ transplant recipients were queried for tonsil disease, tonsillectomy, PTLD diagnosis, transplant history, and immunosuppressants using the associated Current Procedural Terminology, International Classification of Diseases, and RxNorm codes.

Results

We identified 21,582 children with a history of solid organ transplant. Tonsil disease was found in 1833 (8.49 %), and of these patients, 193 (10.53 %) were diagnosed with PTLD within six months. Immunosuppressants associated with higher rates of tonsil disease were tacrolimus (OR 2.74, 95 % CI 2.29–3.28), mycophenolate mofetil (OR 2.72, 95 % CI 2.29–3.24), and cyclosporine (OR 1.50, 95 % CI 1.08–2.10). Sirolimus was associated with lower rates (OR 0.66, 95 % CI 0.52–0.83). EBV diagnosis was associated with both higher rates of tonsil disease (OR 1.45, 95 % CI 1.21–1.72) and PTLD diagnosis (OR 3.52, 95 % CI 2.14–5.77).

Discussion

This is the largest study on tonsillar hypertrophy in PTLD and the first to identify tacrolimus, mycophenolate mofetil, and cyclosporine as significant risk factors for tonsil disease amongst pediatric transplant patients. Understanding risk factors that may predispose a patient to PTLD-mediated tonsil disease can guide decision making to help avoid this complication of immunosuppression.

移植后淋巴细胞增生性疾病（PTLD）是实体器官移植患者免疫抑制的罕见并发症。扁桃体肥大通常是由PTLD引起的，当怀疑是PTLD的原因时，通常进行扁桃体切除术。ptld介导的扁桃体肥大的危险因素仍不明确。本研究旨在确定PTLD诊断后扁桃体肥大的临床和治疗因素。方法：我们使用TriNetX数据库进行回顾性队列研究。使用相关的现行程序术语、国际疾病分类和RxNorm代码查询儿童实体器官移植受者的扁桃体疾病、扁桃体切除术、PTLD诊断、移植史和免疫抑制剂。结果：我们确定了21,582例有实体器官移植史的儿童。扁桃体病变1833例（8.49%），其中193例（10.53%）在6个月内被诊断为PTLD。与扁桃体疾病发生率较高相关的免疫抑制剂有他克莫司（OR 2.74, 95% CI 2.29-3.28）、霉酚酸酯（OR 2.72, 95% CI 2.29-3.24）和环孢素（OR 1.50, 95% CI 1.08-2.10）。西罗莫司与较低的发生率相关（OR 0.66, 95% CI 0.52-0.83）。EBV诊断与扁桃体疾病（OR 1.45, 95% CI 1.21-1.72）和PTLD诊断（OR 3.52, 95% CI 2.14-5.77）的高发率相关。讨论：这是最大的关于PTLD扁桃体肥大的研究，也是首次确定他克莫司、霉酚酸酯和环孢素是儿童移植患者扁桃体疾病的重要危险因素。了解可能使患者易患ptld介导的扁桃体疾病的危险因素可以指导决策，帮助避免这种免疫抑制并发症。

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引用次数: 0

Corrigendum to “Characteristics and prognosis of intractable otomastoiditis caused by nontuberculous mycobacteria” [American Journal of Otolaryngology Volume 46, Issue 6, November–December 2025, 104728] “由非结核分枝杆菌引起的顽固性耳乳囊炎的特征和预后”的勘误表[美国耳鼻咽喉学杂志46卷，第6期，2025年11 - 12月，104728]

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-11-27 DOI: 10.1016/j.amjoto.2025.104751

Bang-Yan Zhang , Chen-Chi Wu , Tien-Chen Liu , Ting-Hua Yang

引用次数: 0

Effectiveness of drug-induced sleep endoscopy in improving patients selection and outcomes of mandibular advancement device therapy for obstructive sleep apnea: A multicenter case-control study 药物诱导睡眠内窥镜在改善下颌推进装置治疗阻塞性睡眠呼吸暂停患者选择和疗效方面的有效性：一项多中心病例对照研究

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-11-11 DOI: 10.1016/j.amjoto.2025.104740

Giannicola Iannella , Sergio Terranova , Marco Brunori , Claudio Vicini , Alberto Caranti , Ruggero Campisi , Vincenzo De Ceglie , Manuele Casale , Antonio Moffa , Fabrizio Salamanca , Federico Leone , Andrea De Vito , Giovanni Cammaroto , Salvatore Cocuzza , Antonino Maniaci , Armando De Virgilio , Jerome R. Lechien , Carlos-Miguel Chiesa-Estomba , Luigi A. Vaira , Paolo Boscolo-Rizzo , Annalisa Pace

Purpose

To evaluate, in Obstructive sleep apnea (OSA) patients, the use of pre-treatment drug-induced sleep endoscopy (DISE) as a patient selection tool, that could improve the outcomes of mandibular advancement device (MAD) therapy. A multicenter retrospective case-control study has been performed.

Methods

A multicenter case-control study with two parallel arms was conducted to compare functional outcomes in patients undergoing MAD therapy. Group A (n = 118) received MAD therapy based solely on static clinical assessments, including dentoskeletal features, oropharyngeal anatomy, and upper airway endoscopy. Group B (n = 87) underwent pre-treatment DISE to dynamically evaluate the site, type, and pattern of upper airway collapse, thereby guiding patient selection for MAD therapy.

Results

In Group A, the mean pre-treatment apnea-hypopnea index (AHI) was 28.1, decreasing significantly to 12.4 post-treatment (p = 0.0001). In Group B, the mean AHI decreased from 31.3 to 9.5 (p = 0.0001). The Delta apnea-hypopnea index (ΔAHI) was significantly greater in Group B (−21.7) than in Group A (−16.6; p = 0.04). Similarly, the Delta Oxigen desaturation index (ΔODI) was −18.6 in Group B versus −14.1 in Group A (p = 0.04). The therapeutic success rate was significantly higher in Group B (82.7 %) compared to Group A (60.1 %) (p = 0.001).

Conclusion

In OSA patients, a pre-treatment DISE evaluation, improves the selection of appropriate candidates for MAD therapy by enabling dynamic assessment of upper airway collapsibility during a pharmacologically induced sleep. This targeted selection results in significantly better therapeutic outcomes for MAD therapy for the OSA treatment.

目的探讨在阻塞性睡眠呼吸暂停（OSA）患者中，治疗前药物诱导睡眠内镜（DISE）作为患者选择工具，对下颌推进装置（MAD）治疗效果的影响。进行了一项多中心回顾性病例对照研究。方法采用双平行臂多中心病例对照研究，比较MAD治疗患者的功能结局。A组（n = 118）仅根据静态临床评估（包括牙骨骼特征、口咽解剖和上呼吸道内窥镜检查）接受MAD治疗。B组（n = 87）在治疗前进行DISE，动态评估上呼吸道塌陷的部位、类型和模式，指导患者选择MAD治疗方案。结果A组患者治疗前平均呼吸暂停低通气指数（AHI）为28.1，治疗后为12.4，差异有统计学意义（p = 0.0001）。B组平均AHI从31.3降至9.5 （p = 0.0001）。B组δ呼吸暂停低通气指数（ΔAHI）（- 21.7）显著高于A组（- 16.6,p = 0.04）。同样，B组的δ氧去饱和指数（ΔODI）为−18.6，而A组为−14.1 （p = 0.04）。B组治疗成功率（82.7%）明显高于A组（60.1%）（p = 0.001）。结论在OSA患者中，治疗前的DISE评估可以通过动态评估药理学诱导睡眠期间的上呼吸道塌陷性来改善对合适的MAD治疗候选者的选择。这种有针对性的选择使MAD治疗OSA的治疗效果明显更好。

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引用次数: 0

Machine learning model for predicting hearing preservation after vestibular schwannoma surgery: A meta-analysis 预测前庭神经鞘瘤手术后听力保存的机器学习模型：荟萃分析。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-11-01 DOI: 10.1016/j.amjoto.2025.104727

Paweł Łajczak , Emma Ann Finnegan , Enzo von Quednow , Fabio Victor Vieira Rocha , Yasmin Picanço Silva , Oguz Kagan Sahin , Walter Fagundes

Introduction

Vestibular schwannomas (VS) are benign tumors that can cause hearing loss, tinnitus and balance disorders. Radiosurgery and open surgery remain the primary treatments, but predicting hearing preservation post-surgery remains challenging due to a variety of factors. Machine learning (ML) has emerged as a promising tool for predicting hearing outcomes in VS patients. This meta-analysis aims to systematically evaluate the diagnostic accuracy of ML models in predicting hearing preservation in VS patients undergoing surgery.

Methods

We conducted a systematic review and meta-analysis following PRISMA-DTA guidelines, including studies that applied ML to predict hearing preservation in VS patients undergoing surgery. Studies were selected based on predefined inclusion criteria, and diagnostic accuracy metrics, such as sensitivity, specificity and accuracy were extracted.

Results

A total of 15 models from 3 studies were included. The overall pooled sensitivity was 0.856 (95% CI 0.758–0.919), specificity was 0.853 (95% CI 0.713–0.931), and accuracy was 0.839 (95% CI 0.748–0.902). The area under the summary ROC curve was 0.883 (95% CI 0.770–0.910), indicating high diagnostic effectiveness. Significant heterogeneity was observed.

Conclusions

ML models achieve high accuracy in predicting hearing preservation in VS patients undergoing surgery. However, significant heterogeneity exists across studies, indicating the need for further research to optimize model performance and enhance their generalizability across diverse patient populations. ML has the potential to assist clinicians in providing personalized treatment strategies and improving patient outcomes in the management of vestibular schwannomas.

前庭神经鞘瘤（VS）是一种良性肿瘤，可引起听力损失、耳鸣和平衡障碍。放疗和开放手术仍然是主要的治疗方法，但由于各种因素，预测术后听力保留仍然具有挑战性。机器学习（ML）已成为预测VS患者听力结果的一种有前途的工具。本荟萃分析旨在系统评估ML模型在预测接受手术的VS患者听力保留方面的诊断准确性。方法：我们根据PRISMA-DTA指南进行了系统回顾和荟萃分析，包括应用ML预测接受手术的VS患者听力保留的研究。根据预定义的纳入标准选择研究，提取诊断准确性指标，如敏感性、特异性和准确性。结果：共纳入3项研究的15个模型。总体合并敏感性为0.856 (95% CI 0.758-0.919)，特异性为0.853 (95% CI 0.713-0.931)，准确性为0.839 （95% CI 0.748-0.902）。综合ROC曲线下面积为0.883 (95% CI 0.77 ~ 0.910)，诊断效能高。观察到显著的异质性。结论：ML模型在预测VS手术患者的听力保留方面具有较高的准确性。然而，各研究之间存在显著的异质性，表明需要进一步研究以优化模型性能并增强其在不同患者群体中的普遍性。ML有可能帮助临床医生提供个性化的治疗策略，并改善前庭神经鞘瘤的治疗结果。

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引用次数: 0

National trends in the utilization of office-based transnasal esophagoscopy 全国办公室经鼻食管镜检查应用趋势

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-11-01 DOI: 10.1016/j.amjoto.2025.104746

Lauren Kwa , Ashley Bodnar , Maxwell Scher , Jacob Pieter Noordzij , Lauren Tracy

Objective

To analyze national trends in the prevalence of office-based transnasal esophagoscopy (TNE) procedures and compare with traditional operating room-based procedures utilizing transoral flexible and rigid esophagoscopy.

Methods

From 2013 to 2022, the US Medicare Part B claims database was searched for Current Procedural Terminology (CPT) codes 43,197/43198: diagnostic transnasal flexible esophagoscopy/with biopsy, 43200/43202: diagnostic transoral flexible esophagoscopy/with biopsy, 43191/43193: diagnostic rigid esophagoscopy/with biopsy. For each CPT code, the total number of charges billed to the Medicare database in each calendar year were recorded and analyzed using trendlines and linear regression.

Results

From 2013 to 2022, there was a significant decrease in the prevalence of transoral flexible esophagoscopy, both diagnostic (trendline slope = −1078, R² = 0.83) and with biopsy (trendline slope = −192, R² = 0.80). The prevalence of rigid esophagoscopy, both diagnostic and with biopsy, remained stable (trendline slope = −51, R² = 0.14; trendline slope = −9.6, R² = 0.26, respectively). Diagnostic TNE represented a small percentage of total diagnostic esophagoscopies performed (range: 9.37–14.94 %), and this percentage remained relatively constant over time (trendline slope = 0.0017, R² = 0.08). TNE with biopsy was a small percentage of total esophageal biopsy procedures (range: 6.54–10.66 %), with a slight increase over time as a percentage of all esophageal biopsies performed (trendline slope = 0.0037, R² = 0.48).

Conclusion

Benefits of office-based TNE procedures include the avoidance of general anesthesia, shorter procedure times, and cost savings. However, TNE remains a small percentage of all esophagoscopies performed, without significant trends toward increased utilization. Further investigation is needed to evaluate the lack of utilization of these office-based procedures.

目的分析全国办公室经鼻食管镜（TNE）手术的流行趋势，并与传统的手术室经口柔性和刚性食管镜手术进行比较。方法从2013年至2022年，检索美国医疗保险B部分索赔数据库，检索当前程序术语（CPT）代码43197 /43198：诊断性经鼻柔性食管镜/活检，43200/43202：诊断性经口柔性食管镜/活检，43191/43193：诊断性刚性食管镜/活检。对于每个CPT代码，每个日历年向医疗保险数据库收取的费用总数被记录下来，并使用趋势线和线性回归进行分析。结果从2013年到2022年，经口柔性食管镜诊断（趋势线斜率= - 1078,R2 = 0.83）和活检（趋势线斜率= - 192,R2 = 0.80）的患病率均显著下降。诊断性和活检性硬食管镜检查的患病率保持稳定（趋势线斜率= - 51,R2 = 0.14；趋势线斜率= - 9.6,R2 = 0.26）。诊断性TNE占全部诊断性食管镜检查的一小部分（范围：9.37 - 14.94%），这一比例随着时间的推移保持相对恒定（趋势线斜率= 0.0017,R2 = 0.08）。活检的TNE占食管活检总手术的百分比很小（范围：6.54 - 10.66%），随着时间的推移，TNE在所有食管活检中所占的百分比略有增加（趋势线斜率= 0.0037,R2 = 0.48）。结论办公室TNE手术的优点是避免了全身麻醉，缩短了手术时间，节省了费用。然而，TNE仍然占所有食管镜检查的一小部分，没有明显的增加使用的趋势。需要进一步调查以评价缺乏利用这些办公室程序的情况。

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引用次数: 0

Audiovisual speech perception in Mandarin cochlear implant users across age and listening conditions 中文人工耳蜗使用者不同年龄及听力状况之视听言语知觉。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-11-01 DOI: 10.1016/j.amjoto.2025.104741

Wen-Ching Chuang , Chia-Chen Lin , Yu-Chien Wang , Shih-Lung Chen , Che-Ming Wu

Objective

To investigate how visual cues influence speech recognition in Mandarin-speaking cochlear implant (CI) users and examine age-related differences in audiovisual (AV) integration across varying sound intensities and noise conditions.

Design

A cross-sectional observational study comparing performance in visual-only (VO), audio-only (AO), and AV conditions using standardized Mandarin monosyllabic word and sentence tests. Study Sample: Seventy-two participants were recruited, including 40 CI users (22 children, 18 adults) and 32 normal-hearing (NH) controls (16 children, 16 adults). All CI users were unilateral recipients of Cochlear™ Nucleus® devices.

Results

AV input significantly enhanced word recognition in CI users, particularly under degraded conditions (low intensity or high noise), consistent with the principle of inverse effectiveness. CI children outperformed adults in AV word tasks, whereas adults had better sentence comprehension. VO performance was comparable between CI and NH groups, suggesting effective visual compensation among CI users. The most pronounced AV benefit was observed at 0 dB signal-to-noise ratio, where AV sentence scores approached AO performance at +5 dB.

Conclusion

AV cues play a critical role in speech perception for Mandarin-speaking CI users, especially under acoustically challenging conditions. Age-specific patterns in AV integration suggest differential reliance on visual input and linguistic strategies. These findings support the inclusion of AV and VO tasks in clinical assessments and underscore the importance of multimodal rehabilitation approaches, particularly for pediatric CI users.

目的：研究视觉线索如何影响普通话人工耳蜗使用者的语音识别，并研究不同声强和噪声条件下视听整合的年龄相关差异。设计：一项横断面观察性研究，通过标准化的普通话单音节单词和句子测试，比较纯视觉（VO）、纯听觉（AO）和纯视听条件下的表现。研究样本：招募了72名参与者，包括40名CI使用者（22名儿童，18名成人）和32名正常听力（NH）对照组（16名儿童，16名成人）。所有CI使用者均为Cochlear™Nucleus®装置的单侧受者。结果：AV输入显著增强了CI用户的单词识别，特别是在退化条件下（低强度或高噪声），符合反向有效性原则。CI儿童在AV单词任务中表现优于成年人，而成年人在句子理解方面表现更好。CI组和NH组之间的VO表现相当，表明CI用户之间存在有效的视觉补偿。在0 dB信噪比时观察到最明显的AV益处，其中AV句子分数接近+5 dB时的AO表现。结论：AV线索在普通话CI使用者的语音感知中起着关键作用，特别是在具有声学挑战性的条件下。视音频整合的年龄特异性模式表明对视觉输入和语言策略的不同依赖。这些发现支持将AV和VO任务纳入临床评估，并强调了多模式康复方法的重要性，特别是对于儿科CI使用者。

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引用次数: 0

Oncocytic lipoadenoma of the submandibular gland case report 颌下腺嗜瘤性脂肪腺瘤1例报告。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-11-01 DOI: 10.1016/j.amjoto.2025.104749

Mina A. Beshy , Fayssal Alqudrah , Isago Jerrett , Andrew M. Parrott , Taha A. Mur

Introduction

Oncocytic lipoadenomas represent a rare, benign variant of salivary gland tumors (SGT). The parotid gland is the most common location for these tumors, accounting for 85 % of cases, followed by the submandibular gland. There have only been 7 reported cases of submandibular gland oncocytic lipoadenomas documented to date.

Main concerns

Herein, we present a case of an asymptomatic 47-year-old female with no significant past medical history who was incidentally diagnosed with a mass of the submandibular gland. We proceeded with complete surgical excision of the left submandibular gland, along with a neck dissection to ensure the removal of any potentially neoplastic tissue.

Primary diagnosis and outcomes

Histopathologic analysis of the excised mass revealed lobulated adipocytic tissue intermixed with small, scattered foci of salivary gland tissue, and several areas of oncocytic glandular tissue surrounded by patchy chronic inflammation, consistent with previously reported findings of oncocytic lipoadenomas.

Conclusions

This case underscores the rarity of this benign entity and highlights its inclusion in the differential diagnosis of salivary gland masses. Furthermore, it emphasizes the importance of diagnostic imaging and histopathologic analysis following core needle biopsy, as biopsy alone may not provide sufficient diagnostic clarity.

嗜细胞性脂腺瘤是一种罕见的、良性的唾液腺肿瘤（SGT）。腮腺是这些肿瘤最常见的部位，占85%的病例，其次是下颌腺。迄今为止，只有7例报告的颌下腺嗜瘤性脂肪腺瘤。主要关注：在此，我们提出一例无症状的47岁女性，没有明显的既往病史，偶然被诊断为颌下腺肿块。我们进行了左侧颌下腺的完整手术切除，同时进行了颈部清扫，以确保切除任何潜在的肿瘤组织。初步诊断和结果：切除肿块的组织病理学分析显示分叶状脂肪细胞组织与小而分散的唾液腺组织混杂在一起，几个嗜瘤细胞腺组织区域被斑片状慢性炎症包围，与先前报道的嗜瘤细胞脂肪腺瘤的结果一致。结论：本病例强调了这种良性实体的罕见性，并强调了其在涎腺肿块鉴别诊断中的重要性。此外，它强调了核心针活检后诊断成像和组织病理学分析的重要性，因为单独活检可能无法提供足够的诊断清晰度。

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