鼻气流诱导法在喉切除术患者嗅觉康复中的疗效:系统回顾与荟萃分析。

IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY International Forum of Allergy & Rhinology Pub Date : 2024-06-30 DOI:10.1002/alr.23391
Kurtis Young MD, Frances T. Morden MD, Quinton Blount MD, Austin Johnson DO, Sameer Kejriwal BS, Hannah Bulosan BS, Elliott J. Koshi MD, Marianne Abouyared MD, Farrah Siddiqui MD, Jee-Hong Kim MD
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引用次数: 0

摘要

简介:这是首次对鼻气流诱导法(NAIM)在全喉切除术(TL)患者嗅觉康复中的有效性进行系统回顾和荟萃分析:我们按照《系统综述和元分析首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-Analyses,PRISMA)指南进行了系统文献检索。纳入标准要求患者必须接受过 TL,随后接受了至少 2 周的 NAIM 训练和嗅觉评估。与基线相比,NAIM 对嗅觉结果的影响得到了衡量。嗅觉测量包括嗅棒测试、嗅盘测试、斯堪的纳维亚气味识别测试和快速气味检测测试。主要结果指标是基线和干预后嗅觉正常患者的比例:从 2000 年到 2023 年的七项研究共纳入了 290 名 TL 患者,符合纳入标准。荟萃分析显示,在干预前,正常泌尿患者的总比例为 0.16(95% 置信区间 [CI]:0.09-0.27,P = 0.01)。干预后,这一比例增至 0.55(95% 置信区间:0.45-0.68,p = 0.001)。在纳入的患者中,88.3%最初为无尿或低尿,NAIM实践后降至48.9%,51.1%达到正常尿量。研究发现,改善比例与TL后的干预时间无明显关系(p = 0.18):结论:NAIM提高了TL患者达到正常泌尿状态的比例。NAIM是一种安全、易学的操作方法,具有良好的效果。我们需要进一步努力,为在临床实践中使用 NAIM 提供具体的建议和指导。
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Efficacy of the nasal airflow-inducing maneuver in the olfactory rehabilitation of laryngectomy patients: A systematic review and meta-analysis

Introduction

This is the first systematic review and meta-analysis to investigate the effectiveness of the nasal airflow-inducing maneuver (NAIM) in olfactory rehabilitation for total laryngectomy (TL) patients.

Methods

We conducted a systematic literature search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The inclusion criteria required that patients must have undergone a TL with subsequent NAIM training for at least 2 weeks and olfactory evaluation. The impact of NAIM on olfactory outcomes compared to that at baseline was measured. Olfactory measures included the Sniffin’ Sticks Test, Smell Disk Test, Scandinavian Odor Identification Test, and Quick Odor Detection Test. The primary outcome measures were the proportion of patients with normosmia at baseline and after intervention.

Results

Seven studies from 2000 to 2023 comprising a total of 290 TL patients met the inclusion criteria. The meta-analysis revealed that prior to intervention, the pooled proportion of patients with normosmia was 0.16 (95% confidence interval [CI]: 0.09‒0.27, p = 0.01). After intervention, the same proportion increased to 0.55 (95% CI: 0.45‒0.68, p = 0.001). Among the included patients, 88.3% were initially anosmic or hyposmic, which was reduced to 48.9% after NAIM practice, with 51.1% achieving normosmia. The percent improvement was not found to be significantly associated with the timing of intervention post-TL (p = 0.18).

Conclusions

NAIM increased the proportion of patients who achieved normosmia in TL patients. NAIM stands out as a safe, easily teachable maneuver with promising results. Further efforts are warranted to provide specific recommendations and guidelines for the use of NAIM in clinical practice.

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来源期刊
CiteScore
11.70
自引率
10.90%
发文量
185
审稿时长
6-12 weeks
期刊介绍: International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy. International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
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