American Journal of Otolaryngology最新文献_第9页

Indication and efficacy of injection laryngoplasty for laryngeal clefts - A retrospective cohort study 喉裂注射成形术的适应症和疗效 - 一项回顾性队列研究

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2024-07-22 DOI: 10.1016/j.amjoto.2024.104425

Marit J.B. van Stigt , Saskia Coenraad , Inge Stegeman , Robert J. Stokroos , Stefaan H.A.J. Tytgat , Maud Y.A. Lindeboom , Arnold J.N. Bittermann

Purpose

Laryngeal cleft (LC) is an anatomical defect of the larynx, where there is a gap (or cleft) between the arytenoids. Milder types can be treated with injection laryngoplasty (IL), involving injection with a filler, resulting in a decreased depth of the cleft and thereby reducing tracheal penetration or aspiration. The effect, however, is temporary. The aim of this study was to investigate the possible indications and the efficacy of IL for LC.

Methods

Patients who underwent IL for LC between March 2018 and June 2023 were retrospectively evaluated. The following parameters were studied: incidence of LC symptoms and objective swallowing evaluations before and after IL, the duration of possible symptom improvement, complications, and the number of subsequent suture repairs.

Results

Eighty-five patients were included. Before IL, 81 (96 %) patients had symptoms of aspiration during feeding, compared to 41 (54 %) patients after IL (p ≤ 0.001). In 42 (49 %) patients, temporary symptom relief occurred, in 22 (26 %) patients symptoms persisted, in 16 (19 %) patients symptoms decreased permanently. Mild complications such as cough and desaturations in the direct postoperative period occurred.

Conclusion

This study shows a statistically significant decrease in the number of parents/caretakers reporting swallowing symptoms after injection laryngoplasty, and a decrease in the average percentage of parents/caretakers reporting various other symptoms. Based on our results, injection laryngoplasty can be recommended as a diagnostic tool in the treatment of laryngeal cleft. Furthermore, it can be used as bridge therapy (i.e. until patients outgrow their symptoms, or until suture repair).

目的喉裂（LC）是喉部的一种解剖缺陷，即杓状肌之间存在间隙（或裂隙）。较轻微的喉裂可通过注射喉成形术（IL）进行治疗，即通过注射填充物来减少裂隙深度，从而减少气管穿入或吸入。然而，这种效果是暂时的。本研究旨在调查IL治疗LC的可能适应症和疗效。方法对2018年3月至2023年6月期间接受IL治疗LC的患者进行回顾性评估。研究了以下参数：IL前后 LC 症状和客观吞咽评估的发生率、症状可能改善的持续时间、并发症以及后续缝合修复的次数。IL 前，81 例（96%）患者在进食时有吸入症状，而 IL 后，41 例（54%）患者有吸入症状（P ≤ 0.001）。42（49 %）名患者的症状暂时缓解，22（26 %）名患者的症状持续存在，16（19 %）名患者的症状永久性减轻。本研究显示，注射式喉成形术后，报告吞咽症状的家长/监护人数量明显减少，报告其他各种症状的家长/监护人的平均比例也有所下降。根据我们的研究结果，建议将注射喉成形术作为治疗喉裂的诊断工具。此外，它还可用作过渡疗法（即直到患者症状消失或缝合修复）。

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引用次数: 0

Impact of ciprofloxacin/dexamethasone on pediatric tracheostomy outcomes 环丙沙星/地塞米松对小儿气管切开术效果的影响。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2024-07-22 DOI: 10.1016/j.amjoto.2024.104406

Pooja D. Reddy , Soukaina Eljamri , Amber D. Shaffer , Reema Padia

Objective(s)

To investigate the effectiveness of ciprofloxacin/dexamethasone in reducing granulation tissue post-tracheostomy in pediatric patients.

Methods

This cohort study examined pediatric patients with a tracheostomy at a single academic institution from 2016 to 2020. Exclusion criteria included: deceased within 1 year (n = 38), >16 years of age (n = 21), decannulated within 1 year (n = 15), lost to follow-up within 1 year (n = 6), and revision tracheostomy (n = 2). Logistic regression or Wilcoxon rank-sum (α = 0.05) were used to compare demographic and clinical characteristics between patients who did and did not receive ciprofloxacin/dexamethasone within 1 year of their tracheostomy.

Results

In this cohort, (n = 126, median age 5.2 months, 54.0 % male), 62.7 % received ciprofloxacin/dexamethasone within 1 year, with 27.8 % taking the nebulized form. Granulation tissue occurred in 81.0 % of cases, predominantly peristomal (69.8 %) and suprastomal (34.9 %). Notable complications included accidental decannulation (13.6 %), suprastomal collapse (11.2 %), and bleeding (7.2 %). Although granulation tissue was more common in ciprofloxacin/dexamethasone users (92.4 %) versus non-users (61.7 %) (OR: 7.55, 95 % CI: 2.73–20.9, p < 0.001), patients exhibited less frequent granulation tissue events after initiation (z = 3.88, p < 0.001). No significant differences in antibiotic resistance (p = 1.0) or endocrinology complications (p = 0.1) were found between those with and without ciprofloxacin/dexamethasone.

Conclusions

We found a statistically significant reduction of granulation tissue incidence with ciprofloxacin/dexamethasone use and no significant differences in antibiotic resistance or endocrinology complications were noted. Future investigation is warranted to explore timing of ciprofloxacin/dexamethasone administration for granulation tissue and its role in managing and preventing tracheostomy complications.

目的：研究环丙沙星/地塞米松对减少小儿气管造口术后肉芽组织的有效性：研究环丙沙星/地塞米松对减少儿科患者气管切开术后肉芽组织的有效性：这项队列研究调查了 2016 年至 2020 年在一家学术机构接受气管造口术的儿科患者。排除标准包括：1年内死亡（n = 38）、年龄大于16岁（n = 21）、1年内停用（n = 15）、1年内失去随访（n = 6）和翻修气管造口术（n = 2）。采用逻辑回归或 Wilcoxon 秩和（α = 0.05）比较气管造口术后 1 年内接受和未接受环丙沙星/地塞米松治疗的患者的人口统计学和临床特征：在该队列中（n = 126，中位年龄为 5.2 个月，54.0% 为男性），62.7% 的患者在 1 年内接受了环丙沙星/地塞米松治疗，其中 27.8% 的患者采用雾化治疗。81.0%的病例出现肉芽组织，主要是肛门周围（69.8%）和肛门上（34.9%）。值得注意的并发症包括意外拔管（13.6%）、瓣上塌陷（11.2%）和出血（7.2%）。尽管肉芽组织在环丙沙星/地塞米松使用者（92.4%）和非使用者（61.7%）中更为常见（OR：7.55，95% CI：2.73-20.9，P 结论：我们发现肉芽组织在环丙沙星/地塞米松使用者中明显减少，而在非环丙沙星/地塞米松使用者中则明显减少：我们发现，使用环丙沙星/地塞米松后肉芽组织的发生率在统计学上有明显降低，而抗生素耐药性或内分泌并发症方面则无明显差异。今后有必要对环丙沙星/地塞米松治疗肉芽组织的用药时机及其在管理和预防气管造口术并发症方面的作用进行研究。

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引用次数: 0

Making a racket in America's fastest growing sport: Evaluation of noise exposure in pickleball 在美国发展最快的运动项目中大显身手：评估皮球运动中的噪音暴露。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2024-07-22 DOI: 10.1016/j.amjoto.2024.104409

Lawrance Lee , Thomas H. Fitzpatrick , Lindsay A. Irwin , Alyssa N. Calder , Nauman F. Manzoor

Objective

To measure noise exposure present on pickleball courts and assess the risk of noise-induced hearing loss (NIHL) per guidelines put forward by the National Institute of Occupational Safety and Health (NIOSH).

Methods

Observational study measuring noise levels at multiple recreational pickleball courts in the Richmond, VA area, documenting LAeq, LASmax, and LCpeak at courtside and waiting areas of pickleball courts. Measurements were completed using the NIOSH SLM application on an iPhone 13 with iMM-6 Calibrated Measurement Microphone (equivalent to IEC 61672-1 Class II) that was calibrated using ND-9 Sound Level Calibrator (IEC942 Class I).

Results

Average sound levels recorded at waiting areas adjacent to the courts, measured in LAeq, LASmax, and LCpeak, were 69.1 dBA, 92.0 dBA, and 112.1 dBC, respectively, while courtside measurements were 69.7 dBA, 92.2 dBA, and 115.6 dBC, respectively. These measurements were within NIOSH and OSHA recommendations.

Conclusion

The data demonstrates that randomly sampled pickleball courts have noise levels that do not increase risk for NIHL for participants or bystanders alike based on NIOSH guidelines. However, prolonged noise exposure and ambient noise pollution may have other health implications and warrant further investigations.

Level of evidence

Level 2.

目的根据美国国家职业安全与健康研究所（NIOSH）提出的指导方针，测量皮球球场的噪音暴露情况，并评估噪音导致听力损失（NIHL）的风险：观察研究：在弗吉尼亚州里士满地区的多个休闲皮球球场测量噪音水平，记录皮球球场边和等候区的 LAeq、LASmax 和 LCpeak。测量是使用 iPhone 13 上的 NIOSH SLM 应用程序和 iMM-6 校准测量麦克风（相当于 IEC 61672-1 II 级）完成的，后者使用 ND-9 声级校准器（IEC942 I 级）进行校准：在球场附近的等候区记录到的平均声级（以 LAeq、LASmax 和 LCpeak 表示）分别为 69.1 dBA、92.0 dBA 和 112.1 dBC，而球场边的测量值分别为 69.7 dBA、92.2 dBA 和 115.6 dBC。这些测量值都在 NIOSH 和 OSHA 的建议范围之内：数据表明，根据 NIOSH 的指导方针，随机抽样的皮球球场的噪音水平不会增加参与者或旁观者患 NIHL 的风险。然而，长期暴露于噪音环境和环境噪音污染可能会对健康产生其他影响，因此需要进一步调查：证据等级：2 级。

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引用次数: 0

Assessment of ChatGPT generated educational material for head and neck surgery counseling 对 ChatGPT 生成的头颈外科手术咨询教育材料进行评估。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2024-07-21 DOI: 10.1016/j.amjoto.2024.104410

Lana Mnajjed , Rusha J. Patel

Background

ChatGPT is becoming very popular as an information source for the public. The adequacy of ChatGPT generated patient counseling material has not yet been extensively assessed.

Methods

ChatGPT was presented with perioperative counseling and complication questions regarding five different procedure, and accuracy of responses was assessed. The chat was then asked to present an explanation of each procedure, and quality of the responses were compared to online educational material.

Results

ChatGPT responses were comprehensive when discussing counseling points commonly discussed by a provider prior to a procedure. Responses to questions on surgical complications were less accurate and comprehensive. In comparison to online educational material, ChatGPT scored at or above the median SAM and PEMAT scores for all procedures.

Conclusions

ChatGPT did well addressing basic counseling points during the perioperative period, although it did not perform as well when addressing surgical complications. Chat response quality was comparable to currently available online educational material.

背景：作为公众的信息来源，ChatGPT 越来越受欢迎。目前尚未对 ChatGPT 生成的患者咨询材料的充分性进行广泛评估：方法：向 ChatGPT 提出了有关五种不同手术的围手术期咨询和并发症问题，并对回答的准确性进行了评估。然后要求聊天者对每种手术进行解释，并将回答的质量与在线教育材料进行比较：结果：在讨论医疗服务提供者在手术前通常会讨论的咨询要点时，ChatGPT 的回答非常全面。对手术并发症问题的回答则不够准确和全面。与在线教材相比，ChatGPT 在所有手术中的得分都达到或超过了 SAM 和 PEMAT 分数的中位数：结论：ChatGPT 在解决围术期基本咨询要点方面表现良好，但在解决手术并发症方面表现不佳。聊天回复质量与目前可用的在线教育材料相当。

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引用次数: 0

Efficacy analysis of the empathy-based attribution analysis-cognitive restructuring-pharmacological treatment model in the management of globus syndrome 基于移情的归因分析--认知重组--药物治疗模式在治疗空洞综合征中的疗效分析

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2024-07-21 DOI: 10.1016/j.amjoto.2024.104421

Ying Wang , Qiaoli Lan , Endian Zheng , Xiaoxiao Lin , Yi Chen , Miaomiao Teng

Objective

The aim of this study is to investigate the clinical efficacy of the empathy-based attribution analysis-cognitive restructuring-pharmacological treatment model for the management of globus syndrome.

Method

Sixty-nine newly diagnosed patients with globus syndrome at the Wenzhou People's Hospital Department of Gastroenterology outpatient clinic were enrolled in this study. After obtaining informed consent, patients were randomly assigned to either the observation group (attribution analysis-cognitive restructuring-classical pharmacotherapy; n = 35) or the control group (pharmacotherapy alone; n = 34), with a treatment course of 4 weeks. Efficacy assessments were conducted before and during treatment using the 9-item Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-15 (PHQ-15).

Results

After four weeks of treatment, the total efficacy rate was 100 % in the observation group and 27.6 % in the control group, with a statistically significant difference between the groups (P < 0.05). Scores on the PHQ-9, GAD-7, and PHQ-15 significantly improved in the observation group compared to before treatment and were better than those in the control group, with statistically significant differences (P < 0.05).

Conclusion

The empathy-based attribution analysis-cognitive restructuring-pharmacological treatment model for the management of globus syndrome demonstrated good clinical efficacy, providing strong evidence for further clinical promotion.

方法选取温州市人民医院消化内科门诊新确诊的69例胃肠综合征患者为研究对象。在获得知情同意后，患者被随机分配到观察组（归因分析-认知重组-经典药物治疗；n=35）或对照组（单纯药物治疗；n=34），疗程为4周。在治疗前和治疗过程中，使用 9 项患者健康问卷-9（PHQ-9）、7 项广泛性焦虑症-7（GAD-7）和患者健康问卷-15（PHQ-15）进行疗效评估。结果治疗 4 周后，观察组的总有效率为 100%，对照组为 27.6%，组间差异有统计学意义（P <0.05）。观察组的PHQ-9、GAD-7、PHQ-15评分与治疗前相比有明显改善，优于对照组，差异有统计学意义（P <0.05）。结论基于移情归因分析-认知重组-药物治疗模式治疗空想综合征取得了良好的临床疗效，为进一步临床推广提供了有力证据。

{"title":"Efficacy analysis of the empathy-based attribution analysis-cognitive restructuring-pharmacological treatment model in the management of globus syndrome","authors":"Ying Wang , Qiaoli Lan , Endian Zheng , Xiaoxiao Lin , Yi Chen , Miaomiao Teng","doi":"10.1016/j.amjoto.2024.104421","DOIUrl":"10.1016/j.amjoto.2024.104421","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study is to investigate the clinical efficacy of the empathy-based attribution analysis-cognitive restructuring-pharmacological treatment model for the management of globus syndrome.</p></div><div><h3>Method</h3><p>Sixty-nine newly diagnosed patients with globus syndrome at the Wenzhou People's Hospital Department of Gastroenterology outpatient clinic were enrolled in this study. After obtaining informed consent, patients were randomly assigned to either the observation group (attribution analysis-cognitive restructuring-classical pharmacotherapy; <em>n</em> = 35) or the control group (pharmacotherapy alone; <em>n</em> = 34), with a treatment course of 4 weeks. Efficacy assessments were conducted before and during treatment using the 9-item Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-15 (PHQ-15).</p></div><div><h3>Results</h3><p>After four weeks of treatment, the total efficacy rate was 100 % in the observation group and 27.6 % in the control group, with a statistically significant difference between the groups (<em>P</em> < 0.05). Scores on the PHQ-9, GAD-7, and PHQ-15 significantly improved in the observation group compared to before treatment and were better than those in the control group, with statistically significant differences (<em>P</em> < 0.05).</p></div><div><h3>Conclusion</h3><p>The empathy-based attribution analysis-cognitive restructuring-pharmacological treatment model for the management of globus syndrome demonstrated good clinical efficacy, providing strong evidence for further clinical promotion.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 5","pages":"Article 104421"},"PeriodicalIF":1.8,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sulcus vocalis. An update 声带沟最新进展

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2024-07-21 DOI: 10.1016/j.amjoto.2024.104395

Regina Helena Garcia Martins, Isabella Gonçalves Pierri, Alessandra Loli, Claudia Mendonça Xavier, Andrea Cristina Joia Gramuglia

引用次数: 0

Comparing the educational quality of YouTube and Facebook videos on tympanostomy tubes 比较 YouTube 和 Facebook 上有关鼓室造口术管的视频的教育质量

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2024-07-21 DOI: 10.1016/j.amjoto.2024.104396

Phillip Q. Richards , Melissa Chavez , Aneesh A. Patel , Lucia S. Ryll , Jessica R. Levi

Purpose

Patients often refer to online materials when researching surgical procedures. This study compares the educational quality of online videos about tympanostomy tubes on two popular video platforms: YouTube and Facebook. This study provides clinicians with context about the content and quality of information patients may possess after watching online videos on tympanostomy tubes.

Materials and methods

YouTube and Facebook were searched using key terms related to tympanostomy tubes. Videos were screened and scored in triplicate. DISCERN quality, content, production, and alternative medicine scores were assigned. Statistical analysis was conducted using GraphPad Prism.

Results

76 YouTube and 86 Facebook videos were analyzed. DISCERN quality scores (mean = 1.8 vs. 1.4, P < .0001), content scores (mean = 1.7 vs. 1.0, P < .0001), and production scores (mean = 4.8 vs. 4.6, P = .0327) were significantly higher on YouTube compared to Facebook. 33 % of Facebook videos referenced alternative medicine, as compared with 0 % of YouTube videos (P < .0001). Physician/hospital-generated videos had significantly higher DISCERN and content scores than parent-, product-, and chiropractor-generated videos. Views did not correlate with DISCERN or content scores.

Conclusion

YouTube is a better platform than Facebook for educational videos about tympanostomy tubes. YouTube videos had higher educational quality, more comprehensive content, and less alternative medicine. One third of Facebook videos advocated for alternative treatments. Importantly, videos on both platforms were of limited educational quality as demonstrated through low DISCERN reliability scores and coverage of few important content areas.

目的患者在研究手术过程时经常会参考在线资料。本研究比较了两个流行视频平台上有关鼓室造口术管道的在线视频的教育质量：YouTube 和 Facebook。本研究为临床医生提供了患者在观看鼓室造口术管在线视频后可能掌握的信息内容和质量的背景资料。材料与方法使用与鼓室造口术管相关的关键术语搜索 YouTube 和 Facebook。对视频进行筛选和评分，一式三份。对 DISCERN 质量、内容、制作和替代医学进行评分。使用 GraphPad Prism 进行了统计分析。结果分析了 76 个 YouTube 视频和 86 个 Facebook 视频。与 Facebook 相比，YouTube 上的 DISCERN 质量得分（平均 = 1.8 vs. 1.4，P < .0001）、内容得分（平均 = 1.7 vs. 1.0，P < .0001）和制作得分（平均 = 4.8 vs. 4.6，P = .0327）明显更高。33% 的 Facebook 视频提到了替代医学，而 YouTube 视频中只有 0% 提到了替代医学（P < .0001）。医生/医院制作的视频的 DISCERN 和内容得分明显高于家长、产品和按摩师制作的视频。结论YouTube 是一个比 Facebook 更好的鼓室造口术管道教育视频平台。YouTube 视频的教育质量更高，内容更全面，替代医学更少。三分之一的 Facebook 视频提倡替代疗法。重要的是，这两个平台上的视频教育质量有限，表现在 DISCERN 可靠性得分较低，覆盖的重要内容领域较少。

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引用次数: 0

Addressing the gaps: What social media tells us about patient experiences with hypoglossal nerve stimulation 弥补差距：社交媒体告诉我们舌下神经刺激术的患者体验。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2024-07-21 DOI: 10.1016/j.amjoto.2024.104419

Mihai A. Bentan, David Moffatt, Emaan Dawood, Ryan Nord

Purpose

Hypoglossal nerve stimulation (HNS) can be an effective treatment for moderate to severe obstructive sleep apnea (OSA) in positive airway pressure (PAP) intolerant patients. To better understand patient perceptions of HNS therapy, we explored three Facebook groups pertaining to HNS therapy.

Materials and methods

A retrospective analysis of Facebook posts from three HNS-related Facebook groups, from October 1, 2022 to October 1, 2023, was performed. Posts were analyzed for author attitude, content (adverse events, inquiries, or sharing information), and the inclusion of media within the post.

Results

From 737 Facebook posts, 752 events were identified, predominantly authored by patients or family (99.5 %). Few posts included media attachments (7.3 %), primarily photos (85.5 %). Post tone was mainly neutral (79.4 %), rather than positive (12.9 %) or negative (7.7 %). Most posts (53.6 %) were queries to the Facebook group, as opposed to sharing information (28.9 %) or detailing adverse events (17.6 %). Notably queries posed by Facebook group members included those pertaining to the postoperative recovery course (10.17 %), physical activity restrictions (6.20 %), HNS therapy eligibility (4.71 %), financial considerations (4.22 %), and more.

Conclusion

Overall, Facebook group members reported a predominantly neutral tone, typically posting queries to the group rather than sharing information or detailing adverse events. These findings illustrate how diverse data sources, such as social media, can enhance our understanding of patient experiences and identify gaps in patient education with HNS therapy.

目的：舌下神经刺激（HNS）可以有效治疗不耐受气道正压（PAP）的中重度阻塞性睡眠呼吸暂停（OSA）患者。为了更好地了解患者对 HNS 治疗的看法，我们调查了三个与 HNS 治疗相关的 Facebook 群组：我们对 2022 年 10 月 1 日至 2023 年 10 月 1 日期间三个 HNS 相关 Facebook 群组的 Facebook 帖子进行了回顾性分析。对帖子的作者态度、内容（不良事件、咨询或分享信息）以及帖子中是否包含媒体进行了分析：从 737 篇 Facebook 帖子中确定了 752 个事件，主要由患者或家属撰写（99.5%）。很少有帖子包含媒体附件（7.3%），主要是照片（85.5%）。帖子的语气以中性为主（79.4%），而非正面（12.9%）或负面（7.7%）。大多数帖子（53.6%）是对 Facebook 群组的询问，而不是分享信息（28.9%）或详细说明不良事件（17.6%）。值得注意的是，Facebook 群成员提出的问题包括术后恢复过程（10.17 %）、身体活动限制（6.20 %）、HNS 治疗资格（4.71 %）、财务考虑（4.22 %）等：总体而言，Facebook 群成员的语气以中性为主，他们通常在群里发布询问，而不是分享信息或详细说明不良事件。这些研究结果表明，社交媒体等不同数据来源可以增进我们对患者经历的了解，并找出 HNS 治疗患者教育方面的不足。

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引用次数: 0

Effect of pre-incident antiplatelet therapy on sudden sensorineural hearing loss 事发前抗血小板治疗对突发性感音神经性听力损失的影响

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2024-07-21 DOI: 10.1016/j.amjoto.2024.104431

Robert M. Conway , Hugh P. Mallany , Zaid Shareef , Nicholas Anthony , Caleb J. Fan , Jacob C. Lucas , Seilesh C. Babu

Objective

Identify if pre-incident aspirin influences severity and outcome of idiopathic sudden sensorineural hearing loss (SSNHL).

Study design

Retrospective review.

Setting

Tertiary care center.

Methods

Patients with idiopathic SSNHL were identified and separated into aspirin and non-aspirin groups. Variables, including demographics, comorbid conditions, audiologic outcomes were identified and compared between groups.

Results

One hundred forty-eight patients were included that met inclusion criteria. There were 38 patients who were on pre-incident aspirin therapy and 110 patients not on aspirin prior to the onset of SSNHL. Pre- and post-treatment audiologic status was worsened in the aspirin group. Other comorbid conditions, including hyperlipidemia, coronary artery disease (CAD), cerebrovascular accident (CVA), and vertigo symptoms had an effect as well. With multivariate analysis, CAD, CVA, and vertigo symptoms appeared to have an effect more than aspirin.

Conclusions

Patients on aspirin have a worsened pre- and post-treatment audiologic status. This appears to be more due to the underlying CAD or history of CVA rather than aspirin use itself.

研究目的确定事发前服用阿司匹林是否会影响特发性突发性感音神经性听力损失（SSNHL）的严重程度和预后：研究设计：回顾性研究：地点：三级医疗中心：确定特发性 SSNHL 患者，并将其分为阿司匹林组和非阿司匹林组。结果：共纳入 148 名特发性 SSNHL 患者：结果：148 名患者符合纳入标准。其中有 38 名患者在 SSNHL 发病前接受过阿司匹林治疗，110 名患者在 SSNHL 发病前未接受过阿司匹林治疗。阿司匹林组患者治疗前和治疗后的听力状况均有所恶化。其他合并症，包括高脂血症、冠状动脉疾病（CAD）、脑血管意外（CVA）和眩晕症状也有影响。通过多变量分析，CAD、CVA 和眩晕症状似乎比阿司匹林的影响更大：结论：服用阿司匹林的患者在治疗前和治疗后的听力状况都会恶化。结论：服用阿司匹林的患者在治疗前和治疗后听力状况都会恶化，这似乎更多是由于潜在的冠状动脉粥样硬化或有过脑梗塞病史，而非服用阿司匹林本身。

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引用次数: 0

Cochlear reimplantation outcomes over 20 years: Expertise in reimplantation surgery and auditory-speech rehabilitation 从事人工耳蜗再植手术 20 余年：再植入手术和听觉言语康复方面的专业知识

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2024-07-21 DOI: 10.1016/j.amjoto.2024.104400

Zhongyan Chen, Qingling Bi, Yong Lv, Yan Li, Wenjing Yang, Xiaoyu Xu, Yuan Li

Objectives

The aim of this study was to present an institution's experience with cochlear reimplantation (CRI), to assess surgical challenges and post-operative outcomes and to increase the success rate of CRI.

Study design

Retrospective single-institution study.

Setting

Tertiary medical center.

Methods

We retrospectively evaluated data from 76 reimplantation cases treated in a tertiary center between 2001 and 2022. Clinical features including etiology of hearing loss, type of failure, surgical issues, and auditory speech performance were analyzed. Categorical Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores were used to evaluate pre- and post-CRI outcomes.

Results

The CRI population comprises of 7 patients from our institute,69 referred patients from other centers. Device failure was the most common reason (68/76, 89.5 %) for CRI; in addition, there were 7 medical failures and 1 had both soft device failure. Medical failures included flap rupture and device extrusion, magnet migration, auditory neuropathy, leukoencephalopathy, foreign-body residue and meningitis. In 21/76 patients, the electrode technology was upgraded. The mean time to failure was 0.58–13 years, with a mean of 4.97 years. The mean (± SD) CAP and SIR scores before and after CRI were 5.2 ± 1.2 versus 5.5 ± 1.1 and 3.4 ± 1.1 versus 3.5 ± 1.1, respectively. Performance was poor in six patients with severe cochlear malformation, auditory nerve dysplasia, leukoencephalopathy, and epilepsy.

Conclusion

CRI surgery is a challenging but relatively safe procedure, and most reimplanted patients experience favorable postoperative outcomes. Medical complications and intracochlear damage are the main causes of poor postoperative results. Therefore, adequate preoperative preparation and atraumatic CRI should be carried out for optimal results.

研究设计回顾性单一机构研究.地点三级医疗中心.方法我们回顾性评估了一家三级医疗中心在 2001 年至 2022 年间治疗的 76 例人工耳蜗再植入术病例的数据。分析了临床特征，包括听力损失的病因、失败类型、手术问题和听觉言语表现。分类听觉表现（CAP）和言语清晰度评分（SIR）用于评估CRI前后的结果。设备故障是 CRI 最常见的原因（68/76，89.5%）；此外，还有 7 例医疗故障和 1 例软设备故障。医疗故障包括皮瓣破裂和装置挤出、磁铁移位、听神经病变、白质脑病、异物残留和脑膜炎。在 21/76 例患者中，电极技术得到了升级。发生故障的平均时间为 0.58-13 年，平均为 4.97 年。CRI 前后的 CAP 和 SIR 评分平均值（± SD）分别为 5.2 ± 1.2 对 5.5 ± 1.1 和 3.4 ± 1.1 对 3.5 ± 1.1。六名患有严重耳蜗畸形、听神经发育不良、脑白质病变和癫痫的患者表现不佳。医疗并发症和耳蜗内损伤是导致术后效果不佳的主要原因。因此，应做好充分的术前准备和无创伤的 CRI 手术，以获得最佳效果。

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