Acta otorrinolaringologica espanola最新文献

IgG4-related disease (IgG4-RD) is a systemic autoimmune fibroinflammatory disease characterized by multiorgan infiltration of IgG4-positive plasma cells, fibrosis and vasculopathy that determine dysfunction of the affected organ. This review aims to characterize the otologic manifestations of the disease.

We have conducted a systematic review of the biomedical literature published describing cases of IgG4-RD with otologic manifestations. For the review, the bibliographic databases utilized were Pubmed, Web of Science and Scopus. We selected 48 cases from which we extracted several data collections.

About 52% of the patients were male between the ages of 19 and 79 years. Otologic findings were characterized by pseudotumoral lesions that most often caused a clinical presentation similar to otitis media with effusion, with cochlear involvement or sensorineural hearing loss (uni- o bilateral). Less frequent presentations included auricular chondritis, eosinophilic otitis, or hypertrophic pachymeningitis. In 32 patients (67%) the otologic manifestation was the first symptom of the ER-IgG4.

Sixteen patients (33%) were treated with mastoidectomies as a result of delayed diagnosis and lack of knowledge about this entity. Two patients needed a cochlear implant.

Although the otologic manifestations of IgG4-RD are unusual, it is important for the otorhinolaryngologist to know the otologic manifestations of this entity as it can be the onset of the disease, in order to allow early diagnosis and adequate treatment, avoiding permanent sequelae.

Objective

The objective of this study was to evaluate the levels of von Willebraund Factor (vWF) in plasma and the protein/creatinine ratio in urine in patients with idiopathic sudden acute hearing loss, which we think to be caused by epithelial dysfunction.

Materials-Methods

Thirty patients with a sudden hearing loss and thirty healthy individuals were included in the study. Before the treatment, blood and urine were collected from the patients and the control group to investigate the levels of the protein/creatinine ratio and the levels of vWF. The test results of the patients group were compared with those of the control group.

Results

We found that the levels of vWF increased in the patient group, which was statistically significant (P < .05). The protein/creatinine ratio in the urine increased in the patient group, but this was not statistically significant (P > .05). In addition, we found that the vWF and urine protein/creatin ratio of the patients who benefited from treatment were lower than those who did not benefit.

Conclusions

This study showed that sudden sensorineural hearing loss may result from endothelial dysfunction. However, more studies that include more patients are needed in order to support this.

Objective

To evaluate the association between results from drug-induced sleep endoscopy (DISE) and computed tomography with lateral cephalometry (CTLC) of the pharynx in obstructive sleep apnea (OSA) patients, regarding the same anatomic level, in order to understand if CTLC could replace DISE in selected patients.

Study design

Cross-sectional.

Setting

Tertiary hospital.

Methods

A total of 71 patients who attended the Sleep Medicine Consultation in the Otorhinolaryngology Department of Hospital CUF Tejo between 1.6.2019 and 30.9.2021, performed a polysomnographic sleep study and were elected to undergo DISE and CTLC of the pharynx for diagnostic purposes were selected. Obstructions at the same anatomic levels – tongue base, epiglottis and velum - were compared in both exams.

Results

Patients with reduction of epiglottis-pharynx space on CTLC had also a complete obstruction at epiglottis level on the VOTE classification of DISE (p = 0,027). Reduction of velum-pharynx space or tongue base-pharynx space were not related to complete obstruction of the velum (P = 0,623) or the tongue base (p = 0,594) found in DISE. Those with two or more space reductions had a tendency to multilevel obstruction observed in DISE (p = 0.089).

Conclusion

When evaluating the obstruction level(s) of an OSA patient, efforts should be made to perform DISE, since CTLC measures, though regarding at the same structures, don´t correlate completely with obstructions observed in DISE.

Aim

A simple and reliable method for diagnosing COVID 19 infections is the needed. The role of saliva in the transmission of the infection has already been established.

Method

Saliva and nasopharyngeal swabs from patients suspected to have COVID 19 infections were taken simultaneously, and the results of the RT-PCR were compared.

Result

Total 405 samples were collected, of which 250 males and 155 females. In the 391 samples included for analysis, 370 (94.63%) samples were found to have concordance results, and 21 (5.37%) samples had discordant results.

Conclusion

The use of saliva to diagnose COVID 19 infection is reliable, and its use can be recommended.

Objective

The objectives of this study were to translate into Spanish, cross-culturally adapt and validate the TFI.

Materials and Methods

The TFI questionnaire translated into Spanish (Sp-TFI) and cross-culturally adapted following the published guidelines on cross-cultural adaptation of health questionnaires was evaluated using two indicators. Its internal consistency was assessed with Cronbach’s α considering the Tinnitus Handicap Inventory (THI) as the gold standard. Further, its test-retest reliability was assessed with intraclass correlation coefficients (ICCs). ICCs were also calculated for the THI and visual analogue scales (VAS) for tinnitus tested and retested in all participants.

Results

The mean age of the 18 participants was 45.77 (SD: 11.87) years; 12 were female (66.67 %) and 6 were male (33.33%). Half of the participants experienced tinnitus in their left ear and half in their right. The mean pure-tone average (PTA) in the affected ear was 29.34 (SD: 8.08) dB-HL. Regarding internal consistency and reliability of the Sp-TFI respectively, Cronbach’s α was 0.83 and the ICC type (2,1) was 1 (CI: 0.99–1). Among the variables studied, we found the following independent predictors had statistically significant effects on THI score: sex (p < 0.01), PTA (p = 0.03), overall Sp-TFI score (p = 0.02) and Sp-TFI SL, R and A subscale scores (p = 0.03, p = 0.03, and p < 0.01, respectively).

Conclusion

Based on the internal consistency and reliability results obtained in this study, the cross-culturally adapted Spanish version of the TFI (Sp-TFI) has been validated for use in Spain.

Level of evidence

2B: Individual cohort study/low-quality randomized control studies

Objective

To determine the percentage of children with permanent bilateral postnatal hearing loss in order to study its incidence, related risk factors, diagnosis and treatment.

Methods

Retrospective study to collect data on children diagnosed with hearing loss outside the neonatal period in the Hearing Loss Unit of the Hospital Universitario Central de Asturias, from April 2014 to April 2021.

Results

52 cases met the inclusion criteria. The detection rate of congenital hearing loss in the neonatal screening programme in the same study period was 1.5 children per thousand newborns per year, adding postnatal hearing loss results in a rate of infant bilateral hearing loss of 2.7 children per thousand (55.5% and 44.4% respectively). Thirty-five children presented risk factors for hearing loss, of which 23 were at retrocochlear risk. The mean age at referral was 91.9 (18–185) months. Hearing aid fitting was indicated in 44 cases (84.6%). Cochlear implantation was indicated in eight cases (15.4%).

Discussion

Although congenital hearing loss accounts for the majority of childhood deafness, postnatal hearing loss has a significant incidence. This may be mainly due to: (1) that hearing impairment may arise in the first years of life, (2) that mild hearing loss as well as hearing loss in severe frequencies are undetectable by neonatal screening in some cases, (3) that some children may have false negative results.

Conclusion

postnatal hearing loss requires identification of risk factors and long-term follow-up of children with hearing loss, as it needs to be detected and treated early.

Objective

To analyse the prognostic ability of the maximum standardised uptake value (SUV_max) on local disease control in patients with oropharyngeal carcinoma treated with radiotherapy.

Material and methods

Retrospective study of 105 patients with oropharyngeal carcinomas treated with radiotherapy, including chemo- and bio-radiotherapy, and who had a PET-CT scan prior to the start of treatment.

Result

Patients with a SUV_max value higher than 17.2 at the primary tumour site had a significantly higher risk of local recurrence. The 5-year local recurrence-free survival for patients with SUV_max less than or equal to 17.2 (n = 71) was 86.5% (95% CI 78.2–94.7 %), and for patients with SUV_max greater than 17.2 (n = 34) it was 55.8% (95% CI 36.0–75.6 %) (P = 0.0001). This difference in local control was maintained regardless of patients' HPV status. Specific survival was similarly lower for patients with a SUV greater than 17.2. The 5-year specific survival for patients with SUV_max greater than 17.2 was 39.5% (95% CI: 20.6–58.3 %), significantly shorter than that of patients with SUV_max equal to or less than 17.2, which was 77.3% (95% CI: 66.9–87.6 %) (P = 0.0001).

Conclusions

Patients with oropharyngeal carcinomas treated with radiotherapy with a SUV_max greater than 17.2 at the level of the primary tumour site had a significantly higher risk of local recurrence.