Ear, nose, & throat journal最新文献

Background: To explore the relevant risk factors of poor prognosis in patients with sudden sensorineural hearing loss (SSNHL), constructing prognostic prediction model, formulating effective treatment strategies, and providing reliable theoretical basis for clinical prevention of and treatment for poor prognosis in SSNHL. Methods: A retrospective analysis was conducted on the clinical data of 123 patients with SSNHL who received treatment at Zhongxian People's Hospital of Chongqing from March 2022 to March 2024. According to the prognosis, they were divided into an effective group (68 cases with an average hearing threshold increase of ≥15 dB, as good prognosis) and an ineffective group (55 cases with an average hearing threshold increase of <15 dB, as poor prognosis). The clinical data from the two patient groups were subjected to both univariate and multivariate logistic regression analyses, allowing for the identification of factors associated with the prognosis of patients with SSHNL. The prediction accuracy of the model was calculated using the receiver operating characteristic (ROC) curves. Results: The results of univariate analysis showed that patients with disease onset time ≥7 days (X² = 35.54, P < .01), past hearing loss (X² = 5.05, P = .03), combined vertigo (X² = 9.45, P < .01), and neutrophil-to-lymphocyte ratio (NLR) (t = 0.46, P = .04) were associated with poor prognosis of SSNHL. The results of multivariate logistic regression analysis showed that disease onset time ≥7 days [odds ratio (OR) = 0.09, P < .01], combined vertigo (OR = 0.24, P < .01), and NLR (OR = 0.92, P = .036) were independent risk factors for the poor prognosis of SSNHL. These factors could also be used as reliable indicators to predict the poor prognosis of SSNHL [area under the ROC curves = 0.766, 0.612, 0.553 respectively]. Conclusion: Disease onset time ≥7 days, combined vertigo, and NLR are independent risk factors and reliable indicators to predict the poor prognosis of SSNHL. Treatment strategies should be developed for high-risk patients of the above types to reduce the occurrence of poor prognosis.

Objective: Concomitant nasopharyngeal and otomastoid tuberculosis (TB) is an extremely rare clinical condition. So far, there have only been 2 such cases reported in English literature, and another 2 such cases have been reported in Chinese literature. The objective of this work is to summarize our experience dealing with this condition and to review the literature. Methods: A retrospective review of cases with concomitant nasopharyngeal and otomastoid TB treated at 2 tertiary medical institutions between June 2022 and May 2024 was undertaken. Data were retrieved from case notes and analyzed. Results: In total, 3 cases were included (2 male patients were from the former institution, and 1 female patient was from the latter). One case was bilateral, and the other 2 cases were unilateral. Their age was between 23 years old and 49 years old (average and median age was 36.3 and 37 years old, respectively). Presenting symptoms included ear fullness, hearing loss, otorrhea, facial paralysis, and otalgia. Careful diagnostic work-up led to the discovery of both otomastoid and nasopharyngeal lesions in all patients. Surgical procedures were planned, and histopathological examination of lesions of both sites was suggestive of TB for all cases, while polymerase chain reaction (PCR) confirmed the presence of Mycobacterium tuberculosis. All patients were subjected to 6 months of anti-TB treatment. The median duration of follow-up was 10 months. No recurrence was documented. A summary of all 7 such cases was also presented. Conclusions: Concomitant nasopharyngeal and otomastoid tuberculosis is very rarely encountered. Surgery or surgical biopsy is important for both treatment and diagnosis. After confirmation of TB by histopathology and PCR, anti-TB treatment is very important for the prevention of recurrence. Symptoms could generally be improved, although not always optimistic.

Objectives: In this study, the graft success and hearing improvement were compared in patients with subtotal or total tympanic membrane perforations following conchal cartilage-reinforced temporalis fascia graft tympanoplasty (CCRTT) versus traditional tragal island cartilage tympanoplasty (TICT). Material and Methods: Fifty Type 1 tympanoplasties performed for subtotal or total tympanic membrane perforation were classified into 2 groups: CCRTT consisted of 23 patients and TICT consisted of 27 patients. The difference between these 2 groups was analyzed by means of graft success, reperforation, and postoperative hearing gain after 12 months. Results: The graft success rate was 96.3% in TICT group and 91.3% in CCRTT group and there was no statistical difference between 2 groups (P > .05). Postoperative pure tone average (PTA) gain was 12.9 ± 9 dB for TICT group and 14 ± 8.8 dB for CCRTT group and postoperative air-bone gap (ABG) gain was 11.2 ± 7.7 dB in TCIT group and 11.3 ± 8.5 dB in CCRTT group and again, there was no statistical difference between these 2 study groups considering PTA and ABG gain (P > .05). Conclusion: Reinforcing tympanic membrane by conchal cartilage in an overlay technique under the anterior tympanic annulus by CCRTT in subtotal and total perforations is as effective as traditional TICT. Considering that graft success is lower in subtotal and total tympanic membrane perforations, both methods can be used interchangeably, depending on the choice of the surgeon.

Background: Malignant transformation of neurofibromas into malignant peripheral nerve sheath tumors (MPNST) is a rare but aggressive phenomenon, particularly in the head and neck region, and is associated with a poor prognosis. The primary treatment modality is surgical excision, often followed by radiotherapy. This is a case report of MPNST in the neck, with long-term follow-up. Case Presentation: A 26-year-old woman presented with a history of multiple progressively enlarging neck swellings for 8 years. The swellings were associated with mild pain and occasional bleeding. The patient had undergone 3 prior surgical excisions, with a fourth recurrence leading to complete excision and split-thickness skin grafting due to extensive raw surface area. Histopathological examination confirmed the diagnosis of MPNST. The patient subsequently received adjuvant chemoradiotherapy due to the aggressive nature of the pathology. Results: The patient has been under regular follow-up for 36 months, with no evidence of local, regional, or distant metastasis. Conclusion: Malignant transformation of neurofibromas is a rare entity, particularly in the head and neck. Early surgical intervention followed by adjuvant chemoradiotherapy provides effective long-term control of the disease and improved survival.

Objectives: In this study, long-term survivors of head and neck cancer (HNC) were evaluated regarding their symptom burden and quality of life (QoL). Methods: This prospective study was performed during the regular follow-up consultations at one of Germany's largest tertiary referral centers for HNC. The assessment included demographic, clinical, and oncological data, as well as the MIDOS(2) and the University of Washington Quality of Life Questionnaire (UW QoL) questionnaires. Patients were subdivided based on their disease stage, that is, early cancer stages (UICC I/II) and advanced cancer stages UICC (III/IV). Results: Between January 1, 2019 and December 31, 2019, 212 HNC patients with a mean follow-up of 46.36 ± 43.64 months were included (120 patients UICC stage I/II (22.5% female, mean age 61.93 ± 12.38 years) versus 92 patients UICC stage III/IV (25.0% female, mean age 63.73 ± 11.74 years)). For all patients evaluated (UICC I/II versus III/IV), the three most common symptoms were tiredness (47.5 vs 60.9%, P = .073, r = .123), anxiety (35.8 vs 32.6%, P = .624, phi = .034) and drowsiness (35.0 vs 44.6%, P = .157, phi = .097). Patients diagnosed with UICC III/IV stages reported loss of appetite significantly more frequently and with a high level of severity (15.0 vs 32.6%, P = .002, phi = .157; 0.23 ± 0.60 vs 0.47 ± 0.78, P = .003, r = .203). The overall symptom burden was low with a severity sum score (min 0-max 30) of 3.04 ± 3.29 versus 3.58 ± 3.38 (P = .143, r = .100). All patients rated their QoL as good (65.67 ± 20.93 vs 59.56 ± 22.00, P = .043, r = .139). Conclusion: The overall symptom burden of long-term survivors of HNC is encouragingly low.Trial registration: The study was registered in the German Registry for Clinical Studies (application No.: 00017122). Date of registration: 15.08.2019. https://drks.de/search/de/trial/DRKS00017122.

Objectives: To assess the effect of voice therapy on pitch in professional singers with faulty respiratory kinematics. Methodology: In this prospective interventional study, professional singers with easy voice fatigability and inability to reach higher pitches, following appropriate selection criteria, were subjected to a 1-month structured voice therapy that transformed their predominant breathing pattern from thoracic to diaphragmatic-abdominal. Acoustic parameters (pitch range and its extreme values before/after therapy, and difference in pitch range) were analyzed using Praat software and compared using standard statistical methods (paired t-test). The singers' age and career duration were also correlated with the pitch parameters (Pearson's correlation coefficient). Results: The singers (n = 60; 55% men, 45% women; respective mean age: 34.24, 35.92 years; average singing career: 12.56 years) had thoracic breathing before treatment [average pitch-range: 92.8 Hz; 85.84 Hz (men), 101.29 Hz (women)] that turned to abdominal type post-therapy [average pitch-range: 189.21 Hz; 178.54 Hz (men), 202.25 Hz (women)]. The decrease in the mean lowest pitch was significant by paired t-test in both men and women (t = 7.96 and 7.87, respectively; .0001 significant level of test), as also the increase in mean highest pitch (t = 23.85 and 17.45, respectively; .0001 significant level of test) and change in pitch range (t = 19.45 and 17.37, respectively; .0001 significant level of test). Correlations between age/career duration with pitch range before and after therapy and its difference varied from very poor to fair [respectively, for men and women, age with pitch range: r = -.54, r = .03 (pre-therapy); r = .045, r = -.39 (post-therapy); age with difference in pitch range: r = .21, r = -.30; singing career with pitch-range: r = -.36, r = .25 (pre-therapy); r = .3, r = -.5 (post-therapy); singing career with difference in pitch range: r = .29, r = -.51]. Conclusions: Voice therapy directed to change respiratory kinematics from thoracic to diaphragmatic-abdominal was significant in the restoration of acoustic voice parameters in professional singers. Their age and duration of singing career had limited roles as adjuncts to voice therapy in the process.

Objective: To investigate the prevalence and other characteristics of editorial self-publication in general otorhinolaryngology journals. Methods: Among the otorhinolaryngology journals indexed in SCI-E in 2023, 12 met the inclusion criteria for the study. The editorial members of the journals were identified from the front matter of all issues published in 2023 and classified according to their editorial role. Original articles, review articles, and case reports were extracted from each journal's archives and the prevalence and other characteristics of articles published by editorial members were investigated independently by 2 authors. Results: A total of 795 editorial members were identified across 12 journals and 185 (23.3%) had at least 1 instance of editor-as-author (EAA), ranging from 11.3% to 41.5%, depending on the journal. Editorial members were listed as an EAA in 290 of the 2106 articles (13.8%), with a range of 5.7% to 54.5%. Original articles were the most common type of editorial self-publication, accounting for 71.7%, followed by review articles (17.6%) and case reports (10.7%). Conclusion: To the best of our knowledge, this is the first study to investigate editorial self-publishing practice in otorhinolaryngology journals and to demonstrate that the prevalence of being an EAA varies widely among otorhinolaryngology journals.

Background: Congenital depigmentation may be associated with congenital sensorineural hearing loss leading to non-development of verbal speech. Objective: To illustrate the clinical features and work-up of 3 children diagnosed with auditory pigmentary disorders (APDs). Methodology: Case series with a review of the literature. Results: The APDs presented here in the 3 children include Waardenburg syndrome type 1, Clouston syndrome, and Waardenburg syndrome type 4 (Waardenburg-Shah syndrome). The characteristic clinical features, audiologic tests, imaging, and the necessary genetic tests carried out subsequently were noted and evaluated. All the children were male and were aged 2 years, 1 year, and 14 months, respectively. All of them had hearing loss and non-development of verbal speech and had some form of oculocutaneous depigmentation. The challenges in the diagnosis, the work-up, and the close differentials were discussed, and the relevant literature was reviewed. Conclusions: The APDs connect congenital depigmentation with prelingual hearing loss through various syndromic disorders. These disorders are not commonly encountered in routine clinical practice; therefore, their proper knowledge is essential for early diagnosis of congenital hearing loss and timely initiation of auditory and speech rehabilitation. This case series deals with a detailed illustration of a few syndromes of the APDs and highlights their clinical presentation and genetic background.

Primary thyroid lymphoma is rare. Hashimoto's disease is usually found as a risk factor. Among thyroid lymphoma, diffuse large B-cell lymphoma (DLBCL) is the most aggressive and frequent one. A 56-year-old man with a medical history of Hashimoto's disease presented with a neck mass and dysphonia. A computed tomography scan revealed a large thyroid mass. Fine-needle aspiration cytology (FNAC) was consistent with lymphoma, confirmed by a core needle as a DLBCL. The patient was transferred to the Department of Hematology and Oncology for chemotherapy with good results. Primary thyroid lymphoma accounts for less than 5% of all thyroid gland malignancies and less than 2% of extranodal lymphomas. It frequently affects women in the sixth or seventh decade. Hashimoto's disease is a major risk factor. DLBCL is the most common histological subtype with aggressive evolution. Radiology and FNAC are not usually very precise and a biopsy is needed. Treatment includes surgery, radiotherapy, chemotherapy, and targeted therapy.