Ear, nose, & throat journal最新文献

Objective: To identify the factors that influence the time to treatment (TT) in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Method: This study included a total of 324 patients with ISSNHL, who were treated at our department between September 2021 and May 2024. Basic information and audiological indicators of patients were collected, and their relationship with the TT was analyzed. Results: The patients were classified into long-term (TT >7 days, n = 75) and short-term groups (TT ≤7 days, n = 249). A significant difference was observed in sex, type of hearing loss, pretreatment hearing threshold, average improved hearing threshold, linear distance, and effective rate between the 2 groups. Conclusion: The average pretreatment hearing threshold and linear distance are related to the TT, and both of them are independent influencing factors. Patients with mild hearing loss and long linear distance from hospital may have a longer TT.

Objective: Cochlear implant (CI) users face the decision of whether to upgrade to a new sound processor (SP) with technological advances. We wanted to assess the changes of speech perception ability and aided hearing thresholds as well as subjective satisfaction after upgrade to a new SP. Methods: Fifty-five patients who have used CI for 10 years or more and upgraded to a new SP were enrolled. Word recognition scores were assessed before the upgrade and compared to those assessed 1 year after the upgrade to the Nucleus 7 SP. Changes of aided hearing thresholds and C- and T-levels were analyzed. Results: Previous SPs were 3G in 5, Freedom in 40, N5 in 24, and N6 in 6. Speech perception remained relatively unaffected by SP upgrade. The C- and T-levels increased after SP upgrading and the aided thresholds with previous generation SPs were higher than those 1 year after SP upgrading at all frequencies. In questionnaires, subjects felt that there was a definite subjective benefit to upgrading while most (60%) felt no difference regarding the communication in noise. Conclusions: Speech perception remained similar, but there were improved hearing sensitivity and better satisfaction after SP upgrade.

Objective: This study aims to assess the efficacy of clarithromycin (CAM) combined with fluticasone propionate (FP) in patients with chronic rhinosinusitis (CRS) after functional endoscopic sinus surgery (FESS), focusing on nasal function, nasal mucociliary transport (MCT) function, and serum inflammatory markers. Methods: The control group (n = 48) was treated with FESS alone, while the study group (n = 48) was treated with FESS plus CAM combined with FP. The clinical effects, symptom scores, nasal function, nasal MCT function, serum inflammatory marker levels, and the occurrence of adverse reactions were compared. Results: The total efficacy rate of the study group (95.83%) was significantly higher than that of the control group (83.33%). After treatment, the study group showed lower symptom scores for nasal congestion, runny nose, sneezing and dizziness, and headache compared to those in the control group. The study group also had lower nasal airway resistance, shorter distance from the minimal cross-sectional area to the nostril, and lower T&T olfactory scores. In contrast, their nasal cavity volume and minimal cross-sectional area were higher than those of the control group. Additionally, the nasal mucociliary clearance and MCT rates were higher in the study group. Serum levels of interleukin-6, interleukin-8, tumor necrosis factor-α, and procalcitonin were significantly lower in the study group compared to the control group (all P < .05). Conclusion: The use of CAM combined with FP in patients after FESS for CRS is effective, leading to the relief of clinical symptoms, improvement of nasal function, enhancement of MCT function, and reduction of inflammatory response, without increasing the incidence of adverse reactions.

Objectives: We investigated the effects of allicin on nasal mucosa via an experimental study. Methods: In the study, 16 male New Zealand Albino (2.5-4.5 kg) rabbits were used. The right nasal passages of the 8 rabbits were included in the control group (Group 1, n = 8), and the right nasal passages of the 8 different rabbits were included in the study group (Group 2, n = 8). In the study group (Group 2), a Merocel tampon soaked in Allicin (Alli Tech; Dulwich Health) (0.5 mg/kg). In the control group (Group 1), a Merocel tampon soaked in serum physiologic was placed in the right nasal passage for 3 days (first to third days of the study). On the fourth day, nasal mucosa was excised and histopathological examinations were performed. Results: Our results showed that there were no significant differences in terms of bleeding, congestion, inflammation, calcification, and seromucous gland density between the study and control groups (P > .05). In light microscopic evaluation, moderate density of lymphocytic cells beneath the surface epithelium and, further down, seromucous gland structures, dense seromucous glands, and occasional ductal structures were observed in the study group. Congested vascular structures beneath the respiratory epithelium and adjacent to a thick-walled vascular structure, coarse calcification is observed in the control group. Conclusion: It has been demonstrated that the Allicin-soaked Merocel pack does not have adverse effects on rabbit nasal mucosa, and it does not lead to mucosal bleeding, congestion, inflammation, and calcification, and changes in the seromucous gland density. Considering the antibacterial and antiviral effects of allicin, it is appropriate to plan research in humans to evaluate its use in nasal packs applied during epistaxis, septoplasty, rhinoplasty, and endoscopic sinus surgery.

Objectives: This study aimed to investigate the effectiveness of polydioxanone (PDS) plate and platelet-rich plasma (PRP) on the regeneration of cartilage grafts, which are frequently used in nasal and septal surgery. Methods: Fifteen white New Zealand Albino-type female rabbits were used in the study. Our study was carried out on 4 different applications on each animal: cartilage only, cartilage+PRP, cartilage+PDS plate, and cartilage+PRP+PDS plate, and in 3 different periods: the first month, the second month, and the third month. Results: A significant difference was obtained between the groups using cartilage+PRP and cartilage+PRP+PDS only in the first month. When both application types were compared, a statistically significant decrease was found in the histopathological cartilage viability score after PDS use. In examining peripheral chondrocyte proliferation, a statistically significant difference was found only in the third-month comparison. When the group using only cartilage was compared with the group using cartilage+PDS, it was determined that peripheral chondrocyte proliferation was significantly reduced at the end of the third month with PDS. In evaluating fibrosis and foreign body reaction, a statistically significant increase was detected using a PDS plate. In histopathological cartilage viability score statistical analysis, a significant difference was obtained between the groups using cartilage+PRP and cartilage+PRP+PDS only in the first month. Degeneration in the cartilage structure was observed macroscopically in the specimens where the PDS plate was used. Shape change and cartilage deformation were observed in the PDS plate specimens. Conclusions: When the results were examined, this observation coincided with the statistically significant increase in foreign body reaction and fibrosis in the PDS plate groups. However, these results contradicted our hypothesis before the study and the information in the literature. Our results will help provide preliminary information and guidance for future studies and offer a different perspective.

To determine the genetic causes of sensorineural hearing loss (SNHL) associated with inner ear anomalies, 11 unrelated Turkish individuals diagnosed with SNHL and an inner ear anomaly using temporal bone computed tomography and inner ear magnetic resonance imaging underwent exome or whole genome sequencing to identify underlying genetic defects. None of the individuals was diagnosed with a recognized syndrome. Four of the 11 probands were homozygous for SLC26A4 variants, c.283G>A, c.845G>A, c.1061T>C, and c.1198delT. Another proband was homozygous for a TECTA variant, c.4163G>A. Patients with variants of the SLC26A4 gene had bilateral enlarged vestibular aqueduct, bilateral incomplete partition type 2 anomaly, bilateral hypoplastic cochlea and bilateral enlarged vestibular aqueduct plus hypoplastic cochlea anomaly. Patients with the variant TECTA gene had bilateral hypoplastic cochlea. This study identified variants of SLC26A4 in 36% of probands with inner ear anomalies. While we identified a variant of the TECTA gene in a proband with cochlear hypoplasia, further studies are needed to see if TECTA variants can cause cochlear malformations.

Sudden idiopathic hearing loss (SIHL) is defined as sensorineural hearing loss at 30 dB or more at 3 consecutive frequencies that begins within 72 hours, and the etiology of the disease is still unclear. Steroid treatment is used as systemic and local (intratympanic) in sudden hearing loss, and different results have been reported for both treatment modalities. This study aimed to compare the results of the treatment in patients who received systemic steroid (SS) therapy and in patients who received systemic and intratympanic steroid (ITS) therapy for SIHL. In all, 169 patients who were admitted to our clinic with the diagnosis of SIHL between January 2007 and June 2018 were randomly divided into 2 treatment groups according to their admittance day, such as patients who received only SSs and patients who received SSs and ITSs. The results of these 2 treatment protocols were investigated. Statistical analysis was performed for all patients by grouping many factors that could be effective in prognosis, such as age, sex, and time of initiation of treatment. No differences were found between the SS group and the combined systemic-ITS group in treatment success. It was determined that being under 15 years of age, over 60 years of age, starting treatment after 7 days, vertigo, high initial hearing loss, descendant type, and total loss type in the audiogram configuration are poor prognostic factors. Being between 16 and 59 years of age, starting treatment within 7 days, having no vertigo, mild hearing loss, and having ascendant and plateau type in audiogram configuration are good prognostic factors. We observed that adding ITS treatment to SS treatment as an initial treatment did not provide any extra benefit. However, prospective, randomized, controlled studies will clarify the topic.