Ear, nose, & throat journal最新文献

Background: Consensus on removing a part of the helical cartilage during preauricular sinus surgery is lacking. A thorough understanding of the histopathological characteristics can improve surgical decisions. Methods: We reviewed the histopathological characteristics of preauricular sinuses in 54 patients who underwent surgery between October 2020 and October 2021. Results: The mean distance between the squamous tract and excised auricular cartilage was 0.38 mm. The maximum tract diameter in primary and recurrent cases was 0.52 cm (range, 0.1-2.8 cm) and 0.42 cm (0.1-1.1 cm), respectively. Mild and severe infections were more frequent in the primary group, whereas moderate infections were more frequent in the recurrent groups. Myofibroblast proliferation was more frequent in recurrent cases than in primary cases. However, cysts, granulation tissue, multinucleated giant cells were more frequent in the primary group. Conclusion: We recommend removal of a small portion of the ascending helix cartilage during preauricular sinus surgery to prevent recurrence. Alternatively, the squamous tract should be carefully dissected from the cartilage to ensure complete sinus excision.

Introduction: Patients frequently use social media to direct their health care. However, the quality of social media posts regarding facial paralysis and reanimation is unclear. Objective: To assess the quality of facial reanimation posts on social media. Methods: Ten key search terms were used to search YouTube and Facebook. The top 10 posts for each search term were graded using a variety of parameters including the Global Quality Score (GQS), Modified DISCERN, Journal of the American Medical Association Criteria, and a novel Social Media Quality Score (SMQS) which was created by the authors. Results: There was a significant difference in SMQS (P = .035) and GQS (P = .01) between YouTube and Facebook Videos. For YouTube videos, there was a significant difference in SMQS scores (P = .003) between various search terms. For Facebook videos, there was a significant difference in both SMQS (P < .0001) and Modified DISCERN (P = .036) scores. The majority of videos evaluated were of moderate or low quality. Conclusion: Higher quality posts regarding facial reanimation are needed on social media. As health care providers, we must provide patients with appropriate resources to find high-quality posts, and when posting content, we must carefully curate the "key words" so that patients can easily find high-quality content.

Introduction: The modified Blair incision is commonly used for superficial and deep lobe lesions of the parotid gland. The most common complication of the parotidectomy procedure is the postoperative surgical scar. Epidermos barrier cream is a type of cream that helps in wound healing by covering the wound. Objective: The purpose of this study was to evaluate the effect of epidermos barrier cream on postoperative incision scars. Methods: Forty-six patients scheduled for surgery due to benign parotid masses were included in the study. Patients were called for a follow-up appointment to remove sutures 1 week after standard surgical intervention. In the study group, epidermos cream was used on the wound site until complete healing was achieved after suture removal, while wound healing in the control group was monitored without any medication. The patients were evaluated in the first, second, and fourth postoperative weeks using a wound site assessment questionnaire and surgical wound assessment for wound healing evaluation. Results: There were no statistically-significant differences between the groups in the evaluation results in the first week. On examination of the data in the second week, a difference was only observed in terms of the presence of hyperemia at the edges of the wound between the groups (P = .005), with no statistically-significant differences found in any other assessment tools. In the 4-week wound healing evaluation, a statistically-significant difference was observed in favor of the study group both in the patient's evaluation of the wound site (P < .001) and in the surgeon's evaluation of the wound site (P = .029). Conclusion: Epidermos cream was found to significantly improve postoperative scar healing in parotidectomy incisions considered challenging in terms of healing. Epidermos barrier cream was found to be beneficial for wound healing in wound sites.

GAPO syndrome is an exceptionally-rare autosomal recessive disorder characterized by growth retardation, alopecia, pseudoanodontia, and optic abnormalities, with fewer than 60 cases reported globally. We present the first documented case in Syria, highlighting novel otolaryngological and radiological findings that expand the clinical spectrum of this syndrome. A 27-year-old male presented with chronic right-sided otalgia, unilateral conductive hearing loss, and persistent sinonasal symptoms. Examination revealed hallmark features of GAPO syndrome, including craniofacial anomalies, external auditory canal stenosis, and pseudoanodontia. Computed tomography demonstrated total aplasia of the paranasal sinuses and mastoid air cells-findings not previously reported in GAPO syndrome. Audiological evaluation revealed moderate conductive hearing loss attributed to external auditory canal stenosis and eustachian tube dysfunction, contrasting with the predominantly-sensorineural hearing loss reported in earlier cases. Additionally, unique ophthalmic findings, including peripheral congenital cataracts and a myelinated retinal nerve fiber layer, were observed. This case underscores the importance of comprehensive evaluations, including advanced imaging and audiological assessments, in identifying subtle or atypical manifestations of GAPO syndrome. It also highlights challenges in airway management due to craniofacial anomalies. The findings emphasize the necessity for a multidisciplinary approach to optimize care and improve outcomes in patients with GAPO. Further research is needed to clarify genotype-phenotype correlations and refine diagnostic criteria.

Background: Chronic cough, a condition defined as a cough persisting for more than 8 weeks, remains a significant clinical challenge with a considerable impact on quality of life. Intranasal corticosteroids (INCS) are widely recommended in clinical guidelines for managing chronic cough, particularly in patients with associated upper airway conditions. However, the evidence base directly supporting this practice is surprisingly sparse, leaving clinicians to navigate a disconnect between guidelines and real-world applicability. Objective: This article offers a critical perspective on the role of INCS in chronic cough management, drawing attention to the paucity of direct evidence and proposing a roadmap for future research. Discussion: A recent systematic review aiming to evaluate the efficacy and safety of INCS for chronic cough yielded no eligible studies, despite extensive database searches. This unexpected outcome highlights a major gap in the literature and raises important questions about the foundation of current guideline recommendations. While INCS are biologically plausible and have demonstrated efficacy in related conditions, such as allergic rhinitis and chronic rhinosinusitis, their specific role in chronic cough remains unverified. The lack of robust clinical trials underscores the need for targeted research to determine whether INCS provide meaningful benefit in this population. Conclusion: The disconnect between recommendations and evidence in chronic cough management underscores a critical need for well-designed randomized controlled trials. Until such data are available, clinicians must balance existing guidelines with clinical judgment, individualizing treatment to address the unique needs of their patients. Bridging this evidence gap will not only enhance patient care but also refine guideline development, ensuring recommendations are firmly grounded in high-quality research.

Introduction: Chronic rhinosinusitis (CRS) and asthma frequently coexhist in children leading to the unified airway theory. Although obesity has been associated with CRS and asthma in adults, studies exploring that association in children are limited. The goal of this study was to evaluate the association between obesity and the unified airway in children. Methods: A retrospective case-control study was performed in children aged 2 to 18 years presenting to our clinic between July 2020 and February 2024. Patient's demographics and comorbidities were reviewed. Children's obesity was classified based on their percentile body mass index of 95% and more. Asthma and CRS diagnoses were determined based on published guidelines. Results: A total of 406 pediatric patients met criteria, with 130 children (32%) with obesity. Children with CRS had a mean computed tomography (CT) Lund-Mackay score of 7.2 (SD of 6.3) and a mean endoscopy modified Lund-Kennedy score of 2.7 (SD of 2.9). Children with obesity were older (11.3 years vs 10.2 years, P = .039) and more likely to have asthma (28.5% vs 15.2%, P = .002) and obstructive sleep apnea (26.2% vs 13%, P = .001). Multivariate logistic regression showed an association between obesity and asthma (OR = 1.84, P = .029), but not with CRS (OR = 1.08, P = .856) or allergic rhinitis (OR = 1.05, P = .856). Conclusion: This study suggests an association between obesity and asthma but not with CRS in children. Further studies should explore whether there is any role for obesity in the treatment of CRS.

Objective: Establish, through the determination of the glottic angle and area, a decision regarding safe and necessary interventions in bilateral vocal fold paralysis to maintain airway. Methods: From January 2008 to December 2023, we looked back at laryngoscopic photographs of subjects with bilateral vocal fold paralysis. The average vocal fold length for each gender was used to calculate the glottic areas and measure the corresponding glottic angles in a total of 26 cases. In order to determine the angles between the anterior commissure and each vocal process, 2 clinicians separately measured the lines and took their average measurement. The average vocal cord length by gender in the Taiwanese data was used to compute the glottic area. Results: The results showed the average glottic angle was 10.3° ± 7.3°. The intervention group (N = 17) had an average glottic angle of 7.1° ± 3.7°. The nonintervention group (N = 9) had an average glottic angle of 16.3° ± 8.9°. The average glottic area was 18.7 ± 10.2 mm², with 14.2 ± 7.5 mm² in the intervention group and 27.2 ± 9. 4 mm² in the nonintervention group. Conclusion: We concluded that emergent airway intervention including intubation or tracheostomy was suggested when the glottic angle <12.2° or glottic area <25.2 mm².

Background: Mucosal contact between the turbinates and septum is implicated as a cause of headache and migraine. The prevalence of mucosal contact is reported to be as low as 4%. However, the inclusion criteria in that study were restrictive, and no data on the superior turbinate were reported. We sought to determine the prevalence of mucosal contact on nasal endoscopy and its association with migraine. Methods: A cohort study of 355 subjects was conducted. All patients underwent nasal endoscopy and were queried as to migraine history. The prevalence of mucosal contact in the migraine cohort was compared to that in the non-migraine cohort, and the prevalence of migraine in the contact cohort was compared to that in the non-contact group. The frequency of mucosal contact at each turbinate involved was noted. Results: The overall prevalence of mucosal contact was 49.3% (175/355). The superior turbinate was most frequently involved (34.9%: 124/355), followed by the inferior turbinate (14.6%; 52/355), the middle turbinate (14.1%: 50/355), and multiple turbinate involvement (13.5%; 48/355). Migraine history was elicited in 31.8% of subjects (113/355); 52% (91/175) of patients with mucosal contact reported migraine history; 65.3% (81/124) with superior turbinate contact, 50% (25/50) with middle turbinate contact, and 21.1% (12/52) with inferior turbinate contact; 80.5% (91/113) of patients with migraine demonstrated mucosal contact; 71.7% (81/113) with superior turbinate contact, 22.1% (25/113) with middle turbinate contact, and 10.6% (12/113) with inferior turbinate contact. Multivariate analysis demonstrated that superior and middle turbinate contact were associated with migraine (P < .001 and P = .034, respectively), but inferior turbinate contact was not (P = .272). Conclusion: Mucosal contact is much more prevalent than previously reported and is associated with migraine, especially at the superior turbinate level.