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Topical Application of 5-Fluorouracil for the Treatment of Sinonasal Adenocarcinoma and Inverted Papilloma. 局部应用 5-氟尿嘧啶治疗鼻窦腺癌和倒置乳头状瘤。
IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-09-01 Epub Date: 2024-06-07 DOI: 10.1177/19458924241260118
Lucy Revercomb, Aman M Patel, Ivan Filimonov, David Lerner, Andrey Filimonov

Background: Sinonasal tumors represent a rare and heterogeneous group of rhinologic neoplasms. Even with advancements in surgical approaches, mortality rates of patients with sinonasal adenocarcinoma (SNAC) have not significantly improved and persistently high rates of recurrence in certain patients with inverted papilloma (IP) are seen. The use of 5-fluorouracil (5-FU) has been successfully described as an adjuvant treatment of SNAC and in the prevention of IP recurrence.

Objective: This review aims to present the current evidence on the management of SNAC and IP with topical 5-FU.

Methods: A three-author independent literature review was conducted to identify research involving the use of topical 5-FU for the treatment of SNAC and IP. A total of nine papers on the treatment of SNAC and IP were collected.

Results: The earliest study looking at the combination of adjuvant low-dose radiation and topical 5-FU for adenocarcinoma of the ethmoid sinus showed a 5-year survival rate of 100%. A follow-up study evaluating a similar protocol reported adjusted disease-free survival at 2, 5, and 10 years of 96%, 87%, and 74%, respectively. Similar results have been demonstrated for adjuvant 5-FU use following endoscopic resection and have even been described in the novel setting of transcutaneous 5-FU delivery following frontal trephination. Topical 5-FU has also been described in the treatment of aggressive IP. The largest case series described the use of 5-FU for eighteen cases and demonstrated only a single recurrence.

Conclusion: The use of topical 5-FU currently represents an underutilized therapeutic modality within the treatment of rhinologic neoplasms. Available literature suggests that neoadjuvant use of topical 5-FU can improve survival and decrease recurrence for SNAC and IP. However, the small sample sizes prevent advocation for routine use in the general population and further research on 5-FU is necessary.

背景:鼻窦肿瘤是一种罕见的异质性鼻科肿瘤。即使手术方法不断进步,鼻窦腺癌(SNAC)患者的死亡率也没有明显改善,某些倒置乳头状瘤(IP)患者的复发率一直居高不下。5-氟尿嘧啶(5-FU)作为鼻窦腺癌(SNAC)的辅助治疗和预防倒置乳头状瘤(IP)复发的药物已被成功应用:本综述旨在介绍目前使用 5-FU 局部治疗 SNAC 和 IP 的证据:方法:我们进行了一项由三位作者独立撰写的文献综述,以确定有关使用局部 5-FU 治疗 SNAC 和 IP 的研究。共收集到九篇关于治疗SNAC和IP的论文:最早对乙状窦腺癌联合使用低剂量放射线和局部 5-FU 辅助治疗的研究显示,5 年生存率为 100%。一项评估类似方案的后续研究报告显示,调整后的2年、5年和10年无病生存率分别为96%、87%和74%。内镜切除术后使用 5-FU 辅助治疗也取得了类似的效果,甚至在额部穿刺术后经皮下注射 5-FU 的新方法中也有类似的描述。外用 5-FU 也被用于治疗侵袭性 IP。最大的病例系列描述了 18 例使用 5-FU 的病例,结果显示只有一例复发:结论:目前,局部使用 5-FU 是治疗鼻腔肿瘤的一种未得到充分利用的治疗方式。现有文献表明,局部 5-FU 新辅助治疗可以提高鼻咽癌和鼻咽癌患者的生存率,降低复发率。然而,由于样本量较小,因此无法在普通人群中常规使用,有必要对 5-FU 进行进一步研究。
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引用次数: 0
Computed Tomography Signs of Sinonasal Inflammation in Patients with Acute Dacryocystitis. 急性泪囊炎患者鼻窦炎的计算机断层扫描征象
IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-09-01 Epub Date: 2024-07-21 DOI: 10.1177/19458924241262098
Yueqi Yu, Guangming Zhou, Xinyu Li, Jinfei Wei, Xiaoyu Ke, Linjuan Wu, Wencan Wu, Bo Yu

Background: Nasal and paranasal sinus abnormalities may be related to nasolacrimal duct obstructive disease but are strongly debated. Data of acute disease stage are lacking.

Objective: The purpose of this study was to determine if there are correlations between radiologic signs of sinus inflammation and acute dacryocystitis (AD).

Methods: This cross-sectional controlled study was conducted at Wenzhou, Zhejiang Province, China from February 2021 to November 2023. Forty-four consecutive patients with AD and 50 consecutive patients with orbital tumors (the control group), who completed preoperative computed tomography scans, were enrolled to evaluate the extent of their inflammatory sinonasal disease by the modified Lund-Mackay score system.

Results: The inflammation signs of the paranasal sinuses (total mean sinus scores, 95% CI [0.00, 2.00]; P < 0.001), namely the anterior ethmoid sinus(95% CI [0.00, 1.00]; P < 0.001), the posterior ethmoid sinus(95% CI [0.00, 0.00]; P = 0.003), the frontal sinus (95% CI [0.00, 0.00]; P = 0.02), and the ostiomeatal complex (P < 0.001) were more extensive in patients with AD when compared with the controls. The disease course was negatively correlated with the anterior ethmoid (P = 0.03) and frontal scores (P = 0.01). The symptom of eyelid swelling was positively correlated with the anterior ethmoid (P = 0.03), ostiomeatal complex (P = 0.004), and total sinus scores (P = 0.005).

Conclusion: Inflammatory sinus disease was found to be more frequent in patients with AD, which was gradually alleviated with the prolongation of the disease course. The mutual spread of inflammation particularly in the acute course may play an important role in lacrimal duct obstructive disease.

背景:鼻腔和副鼻窦异常可能与鼻泪管阻塞性疾病有关,但对此存在激烈的争论。目前还缺乏急性疾病阶段的数据:本研究的目的是确定鼻窦炎的放射学征象与急性泪囊炎(AD)之间是否存在相关性:这项横断面对照研究于 2021 年 2 月至 2023 年 11 月在中国浙江省温州市进行。方法:这项横断面对照研究于 2021 年 2 月至 2023 年 11 月在中国浙江温州进行,研究对象为完成术前计算机断层扫描的 44 例连续性急性泪囊炎患者和 50 例连续性眼眶肿瘤患者(对照组),采用改良的 Lund-Mackay 评分系统评估其鼻窦炎性疾病的程度:副鼻窦(平均鼻窦总分,95% CI [0.00,2.00];P P P = 0.003)、额窦(95% CI [0.00,0.00];P = 0.02)、骨骺复合体(P P = 0.03)和额叶评分(P = 0.01)的炎症体征。眼睑肿胀症状与乙状前窦(P = 0.03)、蝶窦复合体(P = 0.004)和总窦评分(P = 0.005)呈正相关:结论:炎症性鼻窦疾病在 AD 患者中更为常见,并随着病程的延长而逐渐缓解。炎症的相互蔓延,尤其是在急性期,可能在泪道阻塞性疾病中起着重要作用。
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引用次数: 0
Odontogenic Maxillary Sinusitis Microbiology Compared With Chronic Rhinosinusitis: A Meta-Analysis. 牙源性上颌窦炎微生物学与慢性鼻窦炎的比较:一项 Meta 分析。
IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-09-01 Epub Date: 2024-06-17 DOI: 10.1177/19458924241259333
Chang Lu, Yue Zhao, Yicheng Qin, Xi Zhang, Xiaozhe Yang, Yan Zhao, Xiangdong Wang, Jiang Lin

Background: Subtypes of sinusitis have different symptoms and prognoses due to different pathogens. Odontogenic maxillary sinusitis (OMS) mainly occurs unilaterally and is different from chronic rhinosinusitis (CRS) usually occurring bilaterally in terms of clinical characteristics. However, comprehensive microbiological comparisons between OMS and CRS have never been systematically conducted and most comparisons are methodologically biased. This study aims to provide a comprehensive analysis of the microbiology associated with OMS and CRS through a meta-analysis approach in order to provide evidence for differential diagnosis of OMS and CRS from a microbiological perspective.

Methods: The databases PubMed and CNKI were searched from their inception to July 2023. A random-effects model was employed to derive the pooled prevalence estimates of the identified bacterial species or genera.

Results: The 17 represented studies included 6 concerning OMS, 12 concerning CRS, and 4 concerning normal sinus, yielding 191, 610, and 92 samples, respectively. Though not statistically significant, the prevalence of Peptostreptococcus and Prevotella was generally higher in OMS compared to CRS. Notably, Fusobacterium was identified as the only genus with a significantly higher prevalence in OMS compared to CRS.

Conclusion: Fusobacterium was significantly more prevalent in OMS compared with CRS, while Staphylococcus aureus was more prevalent in CRS than in OMS. Such differences in bacterial profile may partly explain the distinct pathology observed and contribute to the development of novel strategies for diagnosis and therapeutic interventions in OMS.

背景:由于病原体不同,鼻窦炎的亚型具有不同的症状和预后。牙源性上颌窦炎(OMS)主要发生在单侧,与通常发生在双侧的慢性鼻窦炎(CRS)在临床特征上有所不同。然而,OMS 和 CRS 之间的全面微生物学比较从未系统地进行过,而且大多数比较在方法上存在偏差。本研究旨在通过荟萃分析方法对与 OMS 和 CRS 相关的微生物学进行全面分析,以便从微生物学角度为 OMS 和 CRS 的鉴别诊断提供证据:方法:对PubMed和CNKI数据库从开始到2023年7月进行了检索。结果:17 项代表性研究中有 6 项涉及 OMS 和 CRS:17项代表性研究中,6项涉及OMS,12项涉及CRS,4项涉及正常鼻窦,分别获得191、610和92个样本。尽管没有统计学意义,但与 CRS 相比,OMS 中肽链球菌和普雷沃茨菌的感染率普遍较高。值得注意的是,与 CRS 相比,镰刀菌是唯一一个在 OMS 中流行率明显较高的菌属:结论:与 CRS 相比,镰刀菌在 OMS 中的流行率明显更高,而金黄色葡萄球菌在 CRS 中的流行率则高于 OMS。细菌谱的这种差异可部分解释所观察到的不同病理现象,并有助于开发新的 OMS 诊断和治疗干预策略。
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引用次数: 0
Management of the Nasolacrimal Duct in Expanded Endoscopic Approaches to the Maxillary Sinus: A Systematic Review with Evidence-based Recommendations. 上颌窦扩大内窥镜方法中的鼻泪管管理:系统回顾与循证建议》。
IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-09-01 Epub Date: 2024-05-27 DOI: 10.1177/19458924241249802
Neal Rajan Godse, Satyan Sreenath, Brian C Lobo, Raj Sindwani

Background: Utilizing expanded endoscopic approaches to the maxillary sinus for the endonasal management of a variety of tumors is increasing in popularity. The nasolacrimal duct (NLD) may be injured inadvertantly or need to be removed during tumor resection or to augment visualization. Management of the NLD can take the form of transection alone, transection with stenting, or performing a formal dacryocystorhinostomy to avoid postoperative sequelae of injury. The purpose of this study was to review the literature and determine the optimal management of the NLD during expanded maxillary sinus approaches.

Methods: A systematic review of Ovid, Embase, Medline, and Cochrane databases was performed to identify studies involving expanded approaches to the maxillary sinus and that explicitly reported the status of the NLD and postoperative outcomes.

Results: Nineteen studies were included in the analysis and divided into two groups: NLD-preserving (n = 9 studies; n = 191 patients in aggregate) and NLD-involving (n = 10 studies; n = 296 patients in aggregate). In the NLD-preserving subgroup, one patient out of a subgroup aggregate of 191 patients (0.5%) developed epiphora. In the NLD-involving subgroup, sharp transection alone was the most common method of NLD removal and was associated with a low rate of epiphora (study rates: 0 to 18.2%; aggregated subgroup rate: 7.0%, 21 / 296). Spontaneous resolution of symptoms was common (60%-100% cases).

Conclusions: The NLD should be preserved when feasible from an exposure and tumor-control perspective. When pathology or approach requires the removal of the NLD, rates of persistent epiphora are very low, regardless of surgical technique. When expanded maxillary approaches are employed, particularly for benign tumors, and require removal of the NLD, sharp transection is the simplest method of removal, provides a low rate of postoperative epiphora, and is supported by the available literature.

背景:利用上颌窦扩大内窥镜方法进行各种肿瘤的鼻内镜治疗越来越受欢迎。鼻泪管(NLD)可能会不慎损伤,或在肿瘤切除过程中需要切除,或为了增强可视性而切除。对鼻泪管的处理可以采取单独横断、横断加支架或进行正式的泪囊鼻腔造口术以避免术后损伤后遗症。本研究的目的是回顾文献,确定上颌窦扩张术中 NLD 的最佳处理方法:方法:对 Ovid、Embase、Medline 和 Cochrane 数据库进行了系统性回顾,以确定涉及上颌窦扩大入路且明确报告了 NLD 状况和术后结果的研究:结果:19 项研究被纳入分析,并分为两组:NLD保留组(9项研究,共191名患者)和NLD涉及组(10项研究,共296名患者)。在 NLD 保护亚组中,191 名患者中有一名患者(0.5%)出现了眼睑外翻。在涉及 NLD 的亚组中,单纯的锐性横切是最常见的 NLD 切除方法,与较低的上睑下垂发生率相关(研究比率:0 至 18.2%;亚组总比率:7.0%,21/296)。症状的自然缓解很常见(60%-100% 的病例):结论:从暴露和肿瘤控制的角度来看,在可行的情况下应保留 NLD。结论:从暴露和肿瘤控制的角度来看,在可行的情况下应保留 NLD。当病理或方法要求切除 NLD 时,无论采用哪种手术技术,持续性上睑下垂的发生率都很低。当采用上颌扩大切口时,尤其是良性肿瘤,需要切除 NLD 时,锐性横切是最简单的切除方法,术后上睑下垂的发生率很低,并得到现有文献的支持。
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引用次数: 0
"Knowledge Is an Unending Adventure at the Edge of Uncertainty." Jacob Bronowski. "知识是在不确定性边缘无休止的探险"雅各布-布朗诺夫斯基
IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-09-01 DOI: 10.1177/19458924241277484
John Schneider
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引用次数: 0
Multi-Institutional Analysis of Insurance Denial Patterns Within Rhinology. 鼻科拒绝保险模式的多机构分析。
IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-07-01 Epub Date: 2024-03-28 DOI: 10.1177/19458924241242856
Tyler A Janz, Najm S Khan, Aatin K Dhanda, Masayoshi Takashima, Arthur W Wu, Dennis M Tang, Thomas S Higgins, Murugappan Ramanathan, Omar G Ahmed

Background: Obtaining insurance approval is a necessary component of healthcare in the United States and denials of these claims have been estimated to result in a loss of 3% to 5% of revenue.

Objective: Examine the trends in insurance denials for rhinological procedures.

Methods: A retrospective review of deidentified financial data of patients who were treated by participating physicians across 3 institutions from January 1, 2021, to June 30, 2023. The data was queried for rhinological and non-rhinological procedures via CPT codes. Cumulative insurance denials were calculated and stratified by procedure and insurance type. Write-offs were dollar amounts associated with final denials.

Results: A sample of 102,984 procedures and visits revealed a final denial rate between 2.2% and 2.9% across institutions (p = .72). The top three rhinological procedures for final write-offs were: nasal endoscopy (16.24%, $111,836.87), nasal debridement or polypectomy (6.48%, $79,457.51), and destruction of intranasal lesion (2.11%, $56,932.20). The write-off percentage for each procedure was highest among commercial insurance payers as opposed to Medicare or Medicaid.

Conclusion: Final denial rates of rhinology procedures ranged between 2% and 3%. Common procedures such as nasal endoscopy and nasal debridement are among the highest written-off procedures. Insurance denials can lead to notable revenue loss. Rhinology practices must continue to remain knowledgeable of the changes and effects of insurance reimbursement on their practice.

背景:在美国,获得保险批准是医疗保健的必要组成部分,据估计,拒绝保险理赔会导致 3% 至 5% 的收入损失:研究鼻科手术保险拒赔的趋势:方法:对 3 家机构的参与医生在 2021 年 1 月 1 日至 2023 年 6 月 30 日期间治疗的患者的去身份财务数据进行回顾性审查。通过 CPT 编码查询鼻科和非鼻科手术数据。计算了累计保险拒付率,并按手术和保险类型进行了分层。注销是指与最终拒付相关的金额:在 102,984 例手术和就诊样本中,各机构的最终拒付率介于 2.2% 和 2.9% 之间(p = .72)。最终核销率最高的三种鼻科手术分别是:鼻内窥镜检查(16.24%,111836.87 美元)、鼻腔清创术或息肉切除术(6.48%,79457.51 美元)和鼻内病变破坏(2.11%,56932.20 美元)。与医疗保险或医疗补助相比,商业保险支付者对每项手术的核销比例最高:结论:鼻科手术的最终拒付率介于 2% 与 3% 之间。鼻内窥镜检查和鼻腔清创术等常见手术是注销率最高的手术之一。保险拒付会导致显著的收入损失。鼻科诊所必须继续了解保险报销的变化和对诊所的影响。
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引用次数: 0
Thoughts on the Surprising Effect of Priming on 22-Item Sino-Nasal Outcome Test (SNOT-22) Results. 关于引物对 22 项中鼻结果测试 (SNOT-22) 结果的惊人影响的思考。
IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-07-01 Epub Date: 2024-03-20 DOI: 10.1177/19458924241240846
Nathan Yang, Adam Waytz, Zachary M Soler, Jonathan B Overdevest, David A Gudis
{"title":"Thoughts on the Surprising Effect of Priming on 22-Item Sino-Nasal Outcome Test (SNOT-22) Results.","authors":"Nathan Yang, Adam Waytz, Zachary M Soler, Jonathan B Overdevest, David A Gudis","doi":"10.1177/19458924241240846","DOIUrl":"10.1177/19458924241240846","url":null,"abstract":"","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Time Burden of Office Visits in Contemporary Pituitary Care, 2016 to 2019. 2016 年至 2019 年当代垂体护理中门诊的时间负担。
IF 2.6 3区 医学 Q1 Medicine Pub Date : 2024-07-01 Epub Date: 2024-03-27 DOI: 10.1177/19458924241242198
Rose C Dimitroyannis, Thomas F Cyberski, Neil S Kondamuri, Sean P Polster, Paramita Das, Peleg M Horowitz, Christopher R Roxbury

Background: The concept of "time toxicity" has emerged to address the impact of time spent in the healthcare system; however, little work has examined the phenomenon in the field of otolaryngology.

Objective: To validate the use of Evaluation and Management (E/M) current procedural terminology codes as a method to assess time burden and to pilot this tool to characterize the time toxicity of office visits associated with a diagnosis of pituitary adenoma between 2016 and 2019.

Methods: A retrospective cohort study of outpatient office visits quantified differences between timestamps documenting visit length and their associated E/M code visit length. The IBM MarketScan database was queried to identify patients with a diagnosis of pituitary adenoma in 2016 and to analyze their new and return claims between 2016 and 2019. One-way ANOVA and two-sample t-tests were used to examine claim quantity, time in office, and yearly visit time.

Results: In the validation study, estimated visit time via E/M codes and actual visit time were statistically different (P < 0.01), with E/M codes underestimating actual time spent in 79.0% of visits. In the MarketScan analysis, in 2016, 2099 patients received a primary diagnosis of pituitary adenoma. There were 8490 additional-related claims for this cohort from 2016 to 2019. The plurality of new office visits were with endocrinologists (n = 857; 29.3%). Total time spent in office decreased yearly, from a mean of 113 min (2016) to 69 min (2019) (P < 0.001).

Conclusions: E/M codes underestimate the length of outpatient visits; therefore, time toxicity experienced by pituitary patients may be greater than reported. Further studies are needed to develop additional assessment tools for time toxicity and promote increased efficiency of care for patients with pituitary adenomas.

背景:时间毒性 "这一概念的出现是为了解决在医疗保健系统中花费的时间所产生的影响;然而,在耳鼻喉科领域却很少有人研究过这一现象:目的:验证使用评估与管理(E/M)当前程序术语代码作为评估时间负担的方法,并试用这一工具来描述 2016 年至 2019 年期间与垂体腺瘤诊断相关的门诊时间毒性:一项门诊就诊的回顾性队列研究量化了记录就诊时长的时间戳与相关E/M代码就诊时长之间的差异。通过查询 IBM MarketScan 数据库,确定了 2016 年诊断为垂体腺瘤的患者,并分析了他们在 2016 年至 2019 年期间的新报销单和返还报销单。采用单因素方差分析和双样本 t 检验来研究索赔数量、诊室时间和年度就诊时间:在验证研究中,通过 E/M 代码估算的就诊时间与实际就诊时间存在统计学差异(P P 结论:E/M 代码低估了就诊时间:E/M 代码低估了门诊就诊时间;因此,垂体瘤患者经历的时间毒性可能大于报告的时间毒性。需要进一步研究开发更多的时间毒性评估工具,提高垂体腺瘤患者的护理效率。
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引用次数: 0
Effects of Endoscopic Sinus Surgery on Olfactory Bulb Volume among Patients with Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis. 内窥镜鼻窦手术对慢性鼻窦炎患者嗅球体积的影响:系统回顾与元分析》。
IF 2.6 3区 医学 Q1 Medicine Pub Date : 2024-07-01 Epub Date: 2024-03-28 DOI: 10.1177/19458924241241874
Xincen Jiang, Tianhao Huang, Feifan Chang, Yu Song, Dawei Wu

Background: Endoscopic sinus surgery (ESS) could significantly improve olfactory function among patients with chronic rhinosinusitis (CRS). This study aimed to perform a meta-analysis to evaluate the effect of ESS on the olfactory bulb volume (OBV) among patients with CRS.

Methods: A systemic search of PubMed, Medline, Embase, Web of Science, and other databases was conducted to identify studies assessing OBV changes in patients with CRS after ESS utilizing magnetic resonance imaging.

Results: A total of four studies with 168 participants were included. Comparing the changes in OBV of patients with CRS before and after surgery within 3-6 months, the ESS significantly improved the overall OBV (P = 0.005, I2 = 66%), with the left OBV increased by 5.57mm3 (P = 0.84, I2 = 0%), and the right OBV increased by 8.63mm3 (P = 0.09, I2 = 53%). A difference in OBV persists between healthy controls and patients with CRS 3-6 months after ESS. The overall OBV of patients with CRS after ESS was significantly smaller than controls (mean difference = -3.84, P = 0.04), with a mean difference of 4.13mm3 on the left side (P = 0.72, I2 = 0%), and a mean difference of 3.22mm3 on the right side (P = 0.0001, I2 = 89%).

Conclusions: ESS significantly increases the OBV among patients with CRS.

背景:内窥镜鼻窦手术(ESS)可显著改善慢性鼻窦炎(CRS)患者的嗅觉功能。本研究旨在进行一项荟萃分析,评估ESS对CRS患者嗅球体积(OBV)的影响:方法:对PubMed、Medline、Embase、Web of Science和其他数据库进行了系统检索,以确定利用磁共振成像评估ESS后CRS患者嗅球体积变化的研究:结果:共纳入了四项研究,168 名参与者。比较CRS患者手术前后3-6个月内的OBV变化,ESS显著改善了整体OBV(P = 0.005,I2 = 66%),左侧OBV增加了5.57mm3(P = 0.84,I2 = 0%),右侧OBV增加了8.63mm3(P = 0.09,I2 = 53%)。健康对照组和 CRS 患者在 ESS 3-6 个月后的 OBV 仍存在差异。ESS后CRS患者的总体OBV明显小于对照组(平均差异=-3.84,P=0.04),左侧平均差异为4.13mm3(P=0.72,I2=0%),右侧平均差异为3.22mm3(P=0.0001,I2=89%):结论:ESS可明显增加CRS患者的OBV。
{"title":"Effects of Endoscopic Sinus Surgery on Olfactory Bulb Volume among Patients with Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis.","authors":"Xincen Jiang, Tianhao Huang, Feifan Chang, Yu Song, Dawei Wu","doi":"10.1177/19458924241241874","DOIUrl":"10.1177/19458924241241874","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic sinus surgery (ESS) could significantly improve olfactory function among patients with chronic rhinosinusitis (CRS). This study aimed to perform a meta-analysis to evaluate the effect of ESS on the olfactory bulb volume (OBV) among patients with CRS.</p><p><strong>Methods: </strong>A systemic search of PubMed, Medline, Embase, Web of Science, and other databases was conducted to identify studies assessing OBV changes in patients with CRS after ESS utilizing magnetic resonance imaging.</p><p><strong>Results: </strong>A total of four studies with 168 participants were included. Comparing the changes in OBV of patients with CRS before and after surgery within 3-6 months, the ESS significantly improved the overall OBV (<i>P</i> = 0.005, I<sup>2 </sup>= 66%), with the left OBV increased by 5.57mm<sup>3</sup> (<i>P</i> = 0.84, I<sup>2 </sup>= 0%), and the right OBV increased by 8.63mm<sup>3</sup> (<i>P</i> = 0.09, I<sup>2 </sup>= 53%). A difference in OBV persists between healthy controls and patients with CRS 3-6 months after ESS. The overall OBV of patients with CRS after ESS was significantly smaller than controls (mean difference = -3.84, <i>P</i> = 0.04), with a mean difference of 4.13mm<sup>3</sup> on the left side (<i>P</i> = 0.72, I<sup>2 </sup>= 0%), and a mean difference of 3.22mm<sup>3</sup> on the right side (<i>P</i> = 0.0001, I<sup>2 </sup>= 89%).</p><p><strong>Conclusions: </strong>ESS significantly increases the OBV among patients with CRS.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Early Endonasal Dacryocystorhinostomy for Acute Dacryocystitis: A Systematic Review and Meta-Analysis. 急性泪囊炎的早期鼻腔内泪囊鼻腔造口术:系统综述与元分析》。
IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 Epub Date: 2024-03-05 DOI: 10.1177/19458924241237009
Jia Li, Jihong Wang, Changling Sun

Objective: The aim of this meta-analysis is to compare the outcomes of early endonasal dacryocystorhinostomy (DCR) with delayed DCR in the treatment of acute dacryocystitis (AD).

Methods: A comprehensive electronic search of PubMed, Embase, Web of Science, and the Cochrane Library databases was conducted up to November 11, 2023. Data synthesis was performed using Review Manager 5.4, and forest plots were generated for each outcome measure. Potential publication bias was assessed using funnel plots and Egger's test.

Results: Six studies involving 288 patients were included in the meta-analysis. Overall, the success rate of early endonasal DCR was comparable to that in the delayed DCR group (odds ratio [OR] = 1.52, 95% confidence interval [CI]: 0.81-2.85, P = .19). Furthermore, in comparison with the delayed DCR group, early endonasal DCR significantly reduced the time for medial canthus swelling resolution (mean differences [MD] = -4.92, 95% CI: -5.46 to 4-.37, P < .00001) and complete resolution of symptoms (MD = -17.70, 95% CI: -23.88 to -11.52, P < .00001).

Conclusion: Primary early endonasal DCR seems to be a promising and favorable approach for managing AD with comparable efficacy and faster relief of symptoms compared to conventional delayed DCR.

目的:本荟萃分析旨在比较早期鼻内泪囊鼻腔吻合术(DCR)与延迟 DCR 治疗急性泪囊炎(AD)的效果:截至 2023 年 11 月 11 日,对 PubMed、Embase、Web of Science 和 Cochrane Library 数据库进行了全面的电子检索。使用Review Manager 5.4进行数据综合,并为每项结果指标生成森林图。使用漏斗图和Egger检验评估潜在的发表偏倚:荟萃分析共纳入了六项研究,涉及288名患者。总体而言,早期鼻内DCR的成功率与延迟DCR组相当(几率比[OR] = 1.52,95%置信区间[CI]:0.81-2.85,P = .19)。此外,与延迟 DCR 组相比,早期鼻内 DCR 显著缩短了内侧角肿胀消退的时间(平均差 [MD] = -4.92,95% 置信区间 [CI]:-5.46 至 4-.37,P P 结论:与传统的延迟 DCR 相比,原发性早期鼻内 DCR 似乎是治疗 AD 的一种有前途的好方法,疗效相当,症状缓解更快。
{"title":"Early Endonasal Dacryocystorhinostomy for Acute Dacryocystitis: A Systematic Review and Meta-Analysis.","authors":"Jia Li, Jihong Wang, Changling Sun","doi":"10.1177/19458924241237009","DOIUrl":"10.1177/19458924241237009","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this meta-analysis is to compare the outcomes of early endonasal dacryocystorhinostomy (DCR) with delayed DCR in the treatment of acute dacryocystitis (AD).</p><p><strong>Methods: </strong>A comprehensive electronic search of PubMed, Embase, Web of Science, and the Cochrane Library databases was conducted up to November 11, 2023. Data synthesis was performed using Review Manager 5.4, and forest plots were generated for each outcome measure. Potential publication bias was assessed using funnel plots and Egger's test.</p><p><strong>Results: </strong>Six studies involving 288 patients were included in the meta-analysis. Overall, the success rate of early endonasal DCR was comparable to that in the delayed DCR group (odds ratio [OR] = 1.52, 95% confidence interval [CI]: 0.81-2.85, <i>P</i> = .19). Furthermore, in comparison with the delayed DCR group, early endonasal DCR significantly reduced the time for medial canthus swelling resolution (mean differences [MD] = -4.92, 95% CI: -5.46 to 4-.37, <i>P</i> < .00001) and complete resolution of symptoms (MD = -17.70, 95% CI: -23.88 to -11.52, <i>P</i> < .00001).</p><p><strong>Conclusion: </strong>Primary early endonasal DCR seems to be a promising and favorable approach for managing AD with comparable efficacy and faster relief of symptoms compared to conventional delayed DCR.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
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American Journal of Rhinology & Allergy
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