Clinical and Experimental Otorhinolaryngology最新文献

{"title":"Evaluation of Risk Factors Associated with the Occurrence and Recurrence of Benign Paroxysmal Positional Vertigo in Koreans: A Nested Case-Control Study.","authors":"Jae Sang Han, Yun-Hee Lee, Ji Hyung Lim, Dong-Hee Lee, Sang Hyun Kwak, Jae-Hyun Seo","doi":"10.21053/ceo.2024.00207","DOIUrl":"https://doi.org/10.21053/ceo.2024.00207","url":null,"abstract":"<p><strong>Objectives: </strong>Benign paroxysmal positional vertigo (BPPV) is the most prevalent cause of vertigo. This study analyzes the risk factors involved in the occurrence and recurrence of BPPV.</p><p><strong>Methods: </strong>A database maintained by the Korean National Health Insurance Service (NHIS) was used to enroll 434,552 patients diagnosed with BPPV from 2011 to 2017. A propensity score was used to match participants with an equal number of control patients without BPPV by age, sex, residential status, and socioeconomic status. Recurrence of BPPV was defined as an occurrence of BPPV more than 90 days after treatment. Logistic regression was used to analyze the occurrence of BPPV, and Cox proportional hazards models were applied to analyze the risk factors for recurrence.</p><p><strong>Results: </strong>BPPV was 2.2 times more common in females, peaking between the ages of 50 and 59 years. The five-year BPPV recurrence rate was 39.8%, with a significant portion recurring within the first year. The incidence of BPPV was statistically significantly associated with several underlying medical conditions, including vitamin D deficiency, thyroid hormone abnormalities, head trauma, and disorders of the inner ear. Advanced age, female gender, rural residence, low socioeconomic status, and the presence of inner-ear diseases were notable risk factors for the recurrence of BPPV.</p><p><strong>Conclusion: </strong>Our study provides significant insight into the risk factors associated with both the occurrence and recurrence of BPPV, which appears to be linked to vitamin D levels, thyroid hormones, and estrogen. Conditions such as inner-ear disorders, head trauma, and otologic surgery were strongly associated with both the occurrence and recurrence of BPPV.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in allergic sensitization and diseases in the Korean general population over a 9-year period.","authors":"Dong Hee Lee, Ji-Hyeon Shin","doi":"10.21053/ceo.2024.00209","DOIUrl":"https://doi.org/10.21053/ceo.2024.00209","url":null,"abstract":"<p><strong>Objectives: </strong>The prevalence of allergic sensitization and diseases varies over time owing to climate, environment, and lifestyle changes. To analyze changes in sensitization to house dust mites (HDM) and dogs and the prevalence of allergic diseases in the Korean general population over a 9-year period and identify contributing factors.</p><p><strong>Methods: </strong>This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey conducted in 2010 and 2019. Participants were aged ≥10 years, with the analysis stratified by adolescents (10-18 years) and adults (≥19 years). We evaluated the prevalence of allergic sensitization and diseases, examining links to clinicodemographic factors, across the two years. Multivariate logistic regression was performed to evaluate the association between sensitization and clinicopathological factors.</p><p><strong>Results: </strong>In total, 4084 participants (2010: n=2,019; 2019: n=2,065) were enrolled. In 2010, HDM sensitization was 36.9%, declining to 36.6% in 2019. Dog sensitization decreased from 6.1% in 2010 to 5.8% in 2019. There were no significant differences between the two years in total participants; however, dog sensitization increased significantly among adolescents (2010: 8.7% vs. 2019: 15.3%; p=.027). In 2010, HDM sensitization was negatively associated with urban residence (odds ratio [95% confidence interval], 0.76 [0.60-0.96]) and apartment dwelling (0.78 [0.64-0.95]), without significance in 2019. In adolescents, dog sensitization was strongly correlated with urban residence (8.06 [1.53-42.49]) in 2010, whereas HDM sensitization was associated with obesity (2.02 [1.04- 3.91]) in 2019. In adults, heavy drinking was linked to dog sensitization (2.35 [1.20-4.62]) in 2010, and HDM sensitization in 2019 (1.44 [1.03-2.02]).</p><p><strong>Conclusion: </strong>: The prevalence of HDM sensitization remained stable over 9 years, with an increase in dog sensitization among adolescents. Factors associated sensitization differed between age groups and years. Understanding these trends and related factors in the general population can inform healthcare providers in developing new strategies to reduce allergic sensitization and diseases.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long Term Surgical Outcome of Canal-Tympanoplasty in Patients with Schuknecht Type B Congenital Aural Stenosis.","authors":"Yoonjae Lee, Moo Kyun Park, Jun Ho Lee, Sang-Yeon Lee, Myung-Whan Suh","doi":"10.21053/ceo.2024.00189","DOIUrl":"https://doi.org/10.21053/ceo.2024.00189","url":null,"abstract":"<p><strong>Background: </strong>Congenital aural atresia (CAA) is a complex condition that can present in various forms, including Schuknecht type B stenosis, characterized by a congenitally narrow bony external auditory canal (EAC). This study aims to evaluate the long-term surgical outcomes of canal-tympanoplasty in patients with CAA Schuknecht type B.</p><p><strong>Methods: </strong>The study included 21 ears diagnosed with CAA Schuknecht type B that underwent canal-tympanoplasty. The large EAC and tympanic membrane were reconstructed using conchal flap meatoplasty, bony EAC drilling, ossicular reconstruction, and overlay tympanoplasty. Standard pure-tone audiometry was analyzed at various time points post-surgery: 3, 6, 12, and 24-60 months. The incidence of postoperative complications was evaluated.</p><p><strong>Results: </strong>The hearing outcomes of canal-tympanoplasty were satisfactory in this case series. Serviceable hearing was achieved in all patients after 3 months and was sustained for 1 year in 85% of patients. The air-bone gap (ABG) improved from 39.3 ± 15.1 dB preoperatively to 13.7 ± 7.4 dB at 3 months, 16.4 ± 10.5 dB at 6 months, 19.1 ± 11.7 dB at 12 months, and 21.5 ± 16.1 dB at 2-5 years postoperatively. Three patients underwent revision canal-tympanoplasty due to hearing deterioration (14.3%). There were no cases of postoperative infection, facial nerve weakness, vertigo, deterioration of bone conduction thresholds, or complete restenosis of the EAC.</p><p><strong>Conclusion: </strong>Canal-tympanoplasty was a satisfactory surgical intervention for patients with CAA Schuknecht type B. The procedure resulted in significant improvements in hearing outcomes, with serviceable hearing that lasted for several years. The risk of postoperative hearing deterioration and/or revision surgery within 1 year was acceptable.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Emergency Room Visit by Head and Neck Cancer Patients: A Longitudinal Cohort Study in the Korean Healthcare System.","authors":"Heejun Yi, Hyojun Kim, Younghac Kim, Ye-Jin Suh, Joo Hyun Park, Nayeon Choi, Han-Sin Jeong","doi":"10.21053/ceo.2024.00257","DOIUrl":"https://doi.org/10.21053/ceo.2024.00257","url":null,"abstract":"<p><strong>Objective: </strong>Due to the application of multiple treatment modalities, a substantial proportion of patients with head and neck cancer (HNC) experience one or more emergency room (ER) visits or unplanned hospitalizations during or after treatment. We investigated HNC cases that visited ERs after cancer treatment to identify potential risk factors in the context of the Korean healthcare system.</p><p><strong>Methods: </strong>This was a single-center cohort study of HNC patients who underwent cancer treatments at OOOO in 2019 (N = 566). The patients were treated with surgery alone (N = 184), surgery plus adjuvant therapy (N = 138), curative non-surgical treatment (radiation or chemo-radiation) (N = 209), or palliative treatments (N = 35). We followed up cases for up to 3 years, who visited the ER after (or during) cancer treatments and analyzed the main reasons and risk factors for ER visits.</p><p><strong>Results: </strong>The rate of ER visits was 8.0% (N = 45) of patients with HNC (no. of ER visits, N = 70, 12.4%, mean = 1.56, range = 1-4), among which treatment-related ER visits made up 4.6%. Common reasons for ER visits were surgical site or wound problems (31.1% per patient, 22.9% per ER visits), and oral intake or feeding problems (22.2% per patient, 31.4% per ER visit). Tumor subsite (17.9% of treatment-related ER visits in hypopharynx cancer), tumor burden (8.6-12.2% in T2-4 and 6.7% in N+ status), and treatment modalities (surgery with adjuvant chemo-radiation, 19.4%) were identified as significant risk factors for ER visits, while patient age and comorbidities were not.</p><p><strong>Conclusion: </strong>The most common causes for ER visits were wound and feeding problems in HNC patients, and tumor factors and treatment modalities were independent risk factors for ER visits. Adequate planning and management to address these problems could help reduce ER visits and costs and improve patient care.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core-Needle Biopsy May Predict Prognosis Preoperatively in Parotid Cancer.","authors":"Jeong-Yeon Ji, Wonjae Cha, Young Ho Jung, Soon-Hyun Ahn, Woo-Jin Jeong","doi":"10.21053/ceo.2024.00227","DOIUrl":"https://doi.org/10.21053/ceo.2024.00227","url":null,"abstract":"<p><strong>Background: </strong>Salivary gland tumors are challenging to diagnose, and preoperative false-negative results often lead to unexpected malignancy diagnosis after parotidectomy. This study aimed to investigate the clinical utility of preoperative core needle biopsy (CNB) diagnosis in patients undergoing primary parotidectomy and its prognostic implications for parotid gland cancers.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study involving 615 patients who underwent preoperative CNB and parotidectomy for primary parotid tumors from 2003 to 2023 at a tertiary referral hospital. Of these, 102 patients diagnosed with primary parotid malignancy post-parotidectomy were analyzed for survival outcomes. DFS and predictive factors were assessed through univariable and multivariable analyses. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CNB were calculated and compared to that of another cohort of 547 patients undergoing ultrasound-guided fine-needle aspiration (FNA) and parotidectomy during the same period.</p><p><strong>Results: </strong>In the CNB group, the 5-year predicted DFS was 86.9% (95% CI, 79.2%-95.3%). Multivariable analysis identified male sex (HR, 8.48; 95% CI, 1.05-68.76) and \"malignant on CNB\" (HR, 8.20; 95% CI, 1.01-66.15) were significantly associated with decreased DFS. CNB demonstrated significantly higher sensitivity (89.0% [95% CI, 81.2%-94.4%]) and NPV (97.6% [95% CI, 95.7%-98.8%]) compared to FNA (sensitivity 45.2% [95% CI, 33.5%-57.3%]; NPV 90.8% [95% CI, 87.7%-93.3%]).</p><p><strong>Conclusion: </strong>Preoperative CNB may predict the prognosis of parotid cancer. Patients with a preoperative \"malignant\" diagnosis on CNB had a poorer prognosis compared to those with a \"less-than-malignant\" diagnosis. CNB also exhibited greater sensitivity than FNA in detecting parotid gland malignancies.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Complex Impact of Smoking Habits on Allergic Rhinitis: A National Cross-Sectional Study.","authors":"Jae-Min Shin, Yujin Jeong, Jaehyeong Kim, Juhyun Lee, Tae Hoon Kim","doi":"10.21053/ceo.2024.00202","DOIUrl":"https://doi.org/10.21053/ceo.2024.00202","url":null,"abstract":"<p><strong>Objectives: </strong>Allergic rhinitis (AR) significantly affects quality of life and generates socioeconomic costs. The impact of smoking habits, including the use of conventional cigarettes (CC) and electronic cigarettes (EC), on AR prevalence and management remains controversial. To investigate the association between smoking status (CC and EC use) and AR prevalence and management among Koreans, data from the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2018) and VIII (2019-2021) were analyzed.</p><p><strong>Methods: </strong>This cross-sectional study included 22,290 participants aged ≥19 years from the KNHANES. Smoking status was self-reported, and urinary cotinine levels were measured to assess nicotine exposure. Statistical analyses, including logistic regression, were employed to examine the relationships between smoking status, cotinine levels, and AR prevalence and management.</p><p><strong>Results: </strong>In univariable logistic regression analysis, compared to non-smokers, electronic cigarette (EC) users showed a 35.8% increased risk of allergic rhinitis (AR), while conventional cigarette (CC) users had a 27.7% lower risk. In multivariable logistic regression analysis, CC users demonstrated a 20.3% lower risk, but no significant association was found among EC users. High cotinine levels (>500 ng/ml) were inversely related to AR prevalence. Among heavy CC users with high cotinine levels, a 35% reduced risk of AR was observed, but after adjusting for confounders, the association was no longer significant, suggesting that other variables may mediate this relationship.</p><p><strong>Conclusion: </strong>Smoking status is associated with the prevalence of allergic rhinitis (AR) in Koreans, and heavy use of conventional cigarettes (CC) shows a negative correlation with AR prevalence.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Assessment of Speech and Swallowing Function in Laryngopharyngeal Cancer Patients After J-Flap Reconstruction.","authors":"Yi-An Lu, Chung-Kan Tsao, Li-Jen Hsin, Hsiu-Feng Chuang, Tuan-Jen Fang","doi":"10.21053/ceo.2024.00109","DOIUrl":"10.21053/ceo.2024.00109","url":null,"abstract":"<p><strong>Objectives: </strong>A novel J-shaped anterolateral thigh (ALT) flap reconstruction technique was developed to simultaneously restore swallowing and speech functions in patients following total laryngopharyngectomy. This study aimed to assess the outcomes and surgical complications in patients who underwent J-flap reconstruction over time.</p><p><strong>Methods: </strong>Patients who underwent J-shaped ALT flap phonatory tube reconstruction were enrolled. Surgical morbidities and outcomes were evaluated every 3 months post-surgery for a period of 12 months or until death.</p><p><strong>Results: </strong>Of the 36 patients, 13 underwent circumferential pharyngeal wall resection (circumferential defect [CD] group), and 23 underwent partial resection (partial defect [PD] group). After 12 months, 97% of the patients were able to resume oral intake without the need for a nasogastric tube, and 50% achieved fluent speech using the reconstructed phonatory tube. The CD group experienced a higher rate of delayed healing than the PD group (30.8% vs. 0%, p=0.012). Additionally, the PD group showed significantly higher percentages of individuals consuming solid food at both the 3- and 12-month intervals than the CD group (81.0% vs. 23.1% and 78.9% vs. 40%, respectively).</p><p><strong>Conclusion: </strong>. This study investigated the progression of speech and swallowing functions over time after reconstruction of the voice tube with a J-flap. Using a J-shaped ALT flap phonatory tube effectively restored both speech and swallowing functions, providing long-term benefits, regardless of whether the defect was circumferential or partial.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"346-354"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video Head Impulse Test Coherence Predicts Vertigo Recovery in Sudden Sensorineural Hearing Loss With Vertigo.","authors":"Sheng-Chiao Lin, Ming-Yee Lin, Bor-Hwang Kang, Yaoh-Shiang Lin, Yu-Hsi Liu, Chi-Yuan Yin, Po-Shing Lin, Che-Wei Lin","doi":"10.21053/ceo.2024.00068","DOIUrl":"10.21053/ceo.2024.00068","url":null,"abstract":"<p><strong>Objectives: </strong>Labyrinthitis significantly reduces quality of life due to prolonged vestibular symptoms in patients experiencing sudden sensorineural hearing loss with vertigo (SSNHLV). This study employed a novel coherence analysis in the video head impulse test (vHIT) to explore vertigo outcomes in SSNHLV patients.</p><p><strong>Methods: </strong>A retrospective review was conducted on 48 SSNHLV patients who completed high-dose steroid treatment between December 2016 and April 2023. Additionally, 38 healthy volunteers were prospectively enrolled from November 2022 to April 2023 at our academic tertiary referral center. The magnitude-squared wavelet coherence between eye and head velocities during the vHIT was measured to assess correlations across frequency bands. Recovery from vertigo, determined by a visual analog scale (VAS) score of 0 at both 2 weeks and 2 months, was analyzed using multivariable Cox regression.</p><p><strong>Results: </strong>The mean VAS for patients with SSNHLV was 5.73±2.45. Higher coherent frequencies in the horizontal semicircular canal (SCC), posterior SCC, and the mean and minimal coherent frequencies of all three SCCs combined were significantly associated with early complete remission of vertigo 2 weeks posttreatment. In the multivariate analysis, the minimal coherent frequency among the three SCCs emerged as an independent factor (hazard ratio, 2.040; 95% CI, 1.776-2.304). Two months posttreatment, in addition to the previously significant parameters, abnormalities in the vestibulo-ocular reflex (VOR) in the posterior SCC, gains in the horizontal and posterior SCCs, total and overt saccades in the horizontal SCC, coherent frequency in the anterior SCC, and mean VOR gain of all three SCCs combined were also statistically significantly related to total relief from vertigo.</p><p><strong>Conclusion: </strong>The highest minimal coherent frequency among the three SCCs significantly contributed to earlier vertigo relief in patients with SSNHLV. Coherence analysis in vHIT may offer greater sensitivity than time series analysis for predicting the prognosis of vertigo.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"282-291"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Significance of Gross Extrathyroidal Extension to Only the Strap Muscle According to Tumor Size in Differentiated Thyroid Cancer: A Systematic Review and Meta-Analysis.","authors":"Ho-Ryun Won, Ji Won Kim, Hyo-One Son, Sumin Yi, Jae Won Chang, Bon Seok Koo","doi":"10.21053/ceo.2024.00162","DOIUrl":"10.21053/ceo.2024.00162","url":null,"abstract":"<p><strong>Objectives: </strong>The presence of extrathyroidal extension (ETE) in patients with differentiated thyroid cancer (DTC) serves as a significant prognostic indicator. Consequently, the staging of DTC is categorized into extensive ETE and gross ETE that solely impacts the strap muscles (gross strap muscle invasion [gSMI]). However, there is a lack of sufficient evidence concerning the relationship between gSMI and prognosis, particularly in terms of tumor size.</p><p><strong>Methods: </strong>Relevant literature was searched in Medline, Embase, Cochrane Library, and KoreaMed. All procedures were conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and carried out by two independent reviewers. The meta-analysis utilized a random-effects model to account for the diversity of the studies. Risk of Bias for Nonrandomized Studies (RoBANS) version 2.0, an evaluation tool for non-randomized studies, was employed to assess the quality of the selected research. Clinical data from observational studies that examined the relationship between the degree of ETE and prognosis were gathered, and a meta-analysis was conducted.</p><p><strong>Results: </strong>Eighteen observational studies were included in this analysis. Subgroup analyses were conducted for each outcome. The findings revealed that the recurrence rate (odds ratio [OR], 2.498), disease-specific mortality (risk ratio [RR], 2.984), overall mortality (RR, 1.361), and lymph node (LN) metastasis (OR, 5.355) were significantly higher in patients with gSMI than in those without ETE. However, when the analysis was restricted to tumors measuring 4 cm or smaller, no significant differences in prognostic outcomes were observed, with the exception of LN metastasis.</p><p><strong>Conclusion: </strong>gSMI negatively impacts prognosis; however, this correlation diminishes with smaller tumor sizes. Thus, a more cautious approach is warranted during the treatment process.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"336-345"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Effectiveness of SNOT 22-Based Interdose Interval Adjustment of Dupilumab for Chronic Rhinosinusitis With Nasal Polyps.","authors":"So Yeon Yoon, HyunKyung Cha, Seung-No Hong, Min-Suk Yang, Dae Woo Kim","doi":"10.21053/ceo.2024.00233","DOIUrl":"10.21053/ceo.2024.00233","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the enduring efficacy and patient satisfaction of dupilumab with interdose interval adjustments based on the Sino-Nasal Outcome Test (SNOT-22) in chronic rhinosinusitis with nasal polyps (CRSwNP).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 44 patients who had been treated with dupilumab for over 6 months. This study targeted individuals diagnosed with CRSwNP according to the 2020 edition of the European Position Paper on Rhinosinusitis and Nasal Polyps Criteria. The treatment involved an add-on dupilumab regimen, where the interdose interval was adjusted based on the SNOT-22 scores. Dosage adjustments were made such that patients with initial SNOT-22 scores greater than 40 were tapered to a target level of 20 or less. Similarly, for patients with initial scores of 40 or less, the treatment aimed for an improvement of 50% or more. At each visit, the effectiveness of the treatment was evaluated using SNOT-22, nasal polyp scores (NPS), and a subjective satisfaction questionnaire adapted from the Treatment Satisfaction Questionnaire for Medication (TSQM v.1.4).</p><p><strong>Results: </strong>The adjustment of the interdose interval for dupilumab based on SNOT-22 scores demonstrated sustained improvements in patients' subjective symptoms, satisfaction, and NPS. The mean (standard deviation) SNOT-22 scores significantly decreased from 46.04 (22.30) to 14.72 (13.66) over 6 months (P<0.001). Similarly, NPS scores improved from 3.20 (2.24) to 1.72 (1.46) within the same period (P<0.001). Satisfaction scores, ranging from 0 to 5, consistently remained above 3.5 for up to 6 months (P=0.166). Additionally, there was a significant correlation between the improvement in the nasal symptom domain of the SNOT-22 scores and higher satisfaction scores.</p><p><strong>Conclusion: </strong>Adjusting dupilumab dosing intervals based on SNOT-22 scores from the outset resulted in sustained efficacy and patient satisfaction in Korean patients with CRSwNP. This approach will meaningfully assist clinicians in determining the optimal dupilumab dosing interval.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"317-325"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}