Ear, nose, & throat journal最新文献

Objectives: We aimed to analyze the influencing factors for residual symptoms following canalith repositioning maneuvers in patients with benign paroxysmal positional vertigo (BPPV). Methods: A total of 193 patients with BPPV who attended our hospital from July 2019 to December 2023 and were followed up in the outpatient clinic for 4 weeks after treatment were selected. The presence or absence of residual symptoms 4 weeks after repositioning was recorded, based on which the patients were assigned into a presence group (n = 72) and an absence group (n = 121). Their general data, incidence features, mental health, and sleep quality were compared. Results: After canalith repositioning maneuver and 4-week follow-up, the Dizziness Handicap Inventory (DHI) scores, Hospital Anxiety and Depression Scale (HADS) scores, and Pittsburgh Sleep Quality Index (PSQI) scores of the BPPV patients significantly decreased (P < .05). The presence of residual symptoms after repositioning in patients with BPPV had significant positive correlations with the time from onset to consultation, DHI score, HADS anxiety score, and PSQI score (P < .05). The area under the curve of the DHI score for predicting residual symptoms after repositioning in patients with BPPV was the largest (0.727), and the time from onset to consultation and the HADS anxiety score had the highest sensitivity (0.764) and specificity (0.801), respectively. Conclusions: Time from onset to consultation, DHI score, HADS anxiety score, and PSQI score are independent risk factors for and display significantly positive correlations with residual symptoms after canalith repositioning maneuver in patients with BPPV.

Auricular mucormycosis is an exceptionally rare and aggressive fungal infection primarily affecting immunocompromised individuals, particularly those with poorly controlled diabetes. This report presents the case of a 54-year-old diabetic woman with isolated auricular mucormycosis and facial nerve palsy. The patient developed right auricular edema, necrosis, and severe pain, progressing over 10 days, with no history of trauma. Initial management included broad-spectrum antibiotics and intravenous liposomal amphotericin B, followed by surgical debridement and partial auricular resection. Despite extensive soft tissue involvement, imaging revealed no bony erosion or significant compression of the facial nerve. Facial nerve function gradually improved from House-Brackmann grade IV to grade II within 38 days. The patient's condition stabilized after sequential surgical interventions and prolonged antifungal therapy, culminating in recovery by day 61. A comprehensive literature review identified 6 documented cases of auricular mucormycosis, all involving diabetic patients, with a mortality rate of 33.3%. Facial nerve paralysis, observed in 4 cases, often persisted despite infection resolution. This case underscores the importance of early diagnosis, aggressive antifungal therapy, surgical debridement, and meticulous management of underlying conditions to optimize outcomes in auricular mucormycosis, a condition with significant diagnostic and therapeutic challenges.

Objective: This study aims to identify the factors influencing decannulation in patients with stroke who underwent tracheostomy during the early subacute phase. Methods: A retrospective analysis was conducted on 219 patients with stroke who underwent a tracheostomy at a tertiary hospital between January 2020 and December 2023. Among them, there were 155 males and 64 females. The age distribution ranged from 13 to 90 years old (average, 54.32 ± 14.96). There were 189 patients diagnosed with cerebral hemorrhage and 30 patients diagnosed with cerebral infarction. The patients were categorized into 2 groups: Those who achieved decannulation during the early subacute phase and those who did not. The decannulation group comprised 69 individuals, while the non-decannulation group comprised 150 individuals. Data collected included general patient demographics, stroke types, levels of consciousness, the presence of airway polyps, and outcomes of the modified Evan's blue dye test (MEBDT). Multivariate logistic regression analysis was employed to identify independent factors influencing early decannulation. The predictive value of these factors was further evaluated using the area under the curve (AUC) from the receiver operating characteristic (ROC) curve analysis. Results: Logistic regression analysis identified Glasgow Coma Scale scores, MEBDT results, and cough ability as independent factors influencing decannulation. ROC curve analysis demonstrated that a predictive model incorporating these 3 factors had a high predictive accuracy, with an AUC of 0.975 (P < .001, 95% CI 0.958-0.993). The model's cut-off value of 0.19 yielded a sensitivity of 95.6% and a specificity of 87.3%. Conclusion: The Glasgow Coma Scale score, MEBDT results, and cough ability are independent determinants of early decannulation is patients with stroke. The combined assessment of these factors offers strong predictive accuracy for early decannulation.

Chondroid syringoma, a mixed tumor of the skin, is an acquired hamartoma that differentiates into hair follicles, sebaceous glands, and apocrine sweat glands. Chondroid syringoma in the ear region is exceptionally rare. However, we present 2 cases of ear chondroid syringoma: 1 involving multiple lesions in the external auditory canal and the other including a single lesion behind the auricle. We reviewed relevant literature to offer insights into the diagnosis and treatment of ear tumors in the future.

Background: Vitamin B12 is an essential nutrient crucial for overall health, and deficiencies can lead to hearing loss. Objective: The aim of the systematic review was to explore the intricate connection between vitamin B12 deficiency and hearing loss using a systematic literature review. Methods: A systematic literature search was carried out to identify the articles exploring the connection between vitamin B12 deficiency and hearing loss. Electronic databases such as PubMed, Scopus, and Cochrane databases were used to identify the relevant studies. Results: A total of 612 studies were identified from 3 databases, and after stepwise screening, 9 articles were found eligible for the data extraction and inclusion in the review. Most of the studies had observed statistically-significant differences in the hearing thresholds with low vitamin B12 levels. However, few studies found hearing loss in the low frequencies (250 and 500 Hz), and others have found elevated thresholds above 4 KHz. Factors such as age, gender, and treatment for vitamin B12 did not show any significant changes in the hearing thresholds. Conclusion: The systematic review revealed that individuals with lower vitamin B12 levels tended to have a higher prevalence of hearing impairment than those with normal or elevated levels. Vitamin B12 deficiency, coupled with high homocysteine levels and low folate concentrations, may contribute to different degrees of hearing loss, particularly in the elderly. Lower serum levels of vitamin B12 have been associated with slight to mild hearing loss, while cochlear dysfunction and poorer hearing thresholds have also been observed in individuals with vitamin B12 deficiency. These findings highlight the importance of maintaining optimal levels of vitamin B12 for preserving hearing health and warrant further investigation into potential interventions.

Objective: Secondhand smoke (SHS) is a major public health concern. In this study, we evaluated the global burden of otitis media (OM) due to SHS exposure during 1990-2019 and explored the impact of socioeconomic factors on it.

Methods: With reference to the 2019 Global Burden of Disease (GBD) data, we assessed the OM burden linked to SHS during 1990-2019, stratified by gender, GBD region, and country. Join-point regression models analyzed trends in OM burden by calculating the average annual percent change (AAPC). Spearman's correlation examined the relationship between the Socio-demographic Index (SDI), Healthcare Access and Quality (HAQ) index, and SHS-related OM burden.

Results: During 1990-2019, age-standardized disability-adjusted life years (ASDRs) and age-standardized mortality rates (ASMRs) for OM due to SHS declined globally, with AAPCs of -1.45 for ASDR and -7.97 for ASMR. Significant declines in ASMR were noted in low-to-middle SDI regions. Regionally, Eastern Sub-Saharan Africa had the highest OM-related deaths, while South Asia had the highest disability-adjusted life years. OM burden decreased with higher SDI and HAQ.

Conclusion: Despite global declines, significant regional and national disparities remained, which emphasizes the need for targeted interventions.

Objective: To compare the efficacy of surgical treatment in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) involving a standalone modified uvulopalatopharyngoplasty (mUPPP) and radiofrequency coblation inferior turbinoplasty with mUPPP. Methods: In this study, a retrospective analysis of 79 OSAHS patients with inferior turbinate hypertrophy and oropharyngeal obstruction undergoing surgical treatment was performed. According to the different surgical methods, the patients were divided into 2 groups (Group A and Group B). Group A included 36 patients treated with standalone mUPPP. Group B included 43 patients treated with mUPPP and bilateral radiofrequency coblation inferior turbinoplasty. Polysomnography (PSG), active anterior rhinomanometry, surgical success rate, and surgical complication were used to assess the patients in 2 groups. The successful surgical result was defined as a 50% or greater decrease in the apnea-hypopnea index (AHI) in postoperative PSG. Results: Before surgery, there were no significant differences in age, gender, neck circumference, body mass index, Friedman tongue position grade, tonsil size grade, Epworth sleepiness scale score, total inferior turbinate size grade, total nasal resistance (TNR), AHI and the lowest O₂ saturation (LSaO₂) between the 2 groups. After 6 months of follow-up visits, AHI, LSaO₂, and TNR in Group B showed a significant improvement compared to Group A. The surgical success rate was 76.74% in Group B compared to 52.78% in Group A (P = .025). There was no significant difference in the total surgical complication rate between the 2 groups (13.89% vs 23.26%, P = .290). Conclusion: For OSAHS patients with inferior turbinate hypertrophy and oropharyngeal obstruction, radiofrequency coblation inferior turbinoplasty with mUPPP appears to be a more effective surgical method than mUPPP alone.

Cavernous hemangiomas of the external auditory canal simultaneously affecting the tympanic membrane are extremely rare. Endoscopic otosurgery has been successfully used for resecting various ear lesions because of its wider surgical field of view and minimal trauma. We report the case of a 50-year-old male patient who presented with a 6-month history of left ear congestion. Otoendoscopic examination of the left ear revealed a dark red neoplasm blocking the bony external auditory canal. After admission, surgical contraindications were eliminated, and the patient underwent otoendoscopic resection of the canal tumor. Postoperatively, the patient's symptoms were relieved, and there was no reoccurrence during the 1-month follow-up. The tumor was successfully removed using otoendoscopy, followed by tympanoplasty.