Clinical Otolaryngology最新文献

{"title":"Adverse Effects of Steroid Therapy in Sudden Sensorineural Hearing Loss: A Scoping Review.","authors":"M Achanta, P Kasetti, M Fortune-Ely, T Ross, T Magos, J G Manjaly","doi":"10.1111/coa.14339","DOIUrl":"https://doi.org/10.1111/coa.14339","url":null,"abstract":"<p><strong>Objective: </strong>Sudden sensorineural hearing loss (SSNHL) is an otologic emergency and is treated with steroid therapy. Despite adverse events (AEs) associated with long-term steroid use being well evidenced, there is sparsity of literature regarding the AEs of short-course prescriptions in the SSNHL cohort, which limits the quality of patient counselling and informed consent.</p><p><strong>Method: </strong>A literature search was performed on the Medline and Embase databases for studies assessing AEs in adults with SSNHL managed with oral (OST), intratympanic (ITS) and intravenous steroid therapy (IVS). Two authors screened titles, abstracts and full-text articles, with conflicts resolved by a third reviewer. Forty-three papers were included.</p><p><strong>Results: </strong>In systemic steroid therapies, hyperglycaemia and hypertension are reported in up to 29.8% and 37.9% of patients respectively. Patients with medication-dependent diabetes and hypertension are at higher risk. Gastric and mood disturbances affected up to 27.9% and 44.6% of patients respectively. ITS carried risks of otalgia (up to 54.3%), dizziness (up to 27.1%), perforations (up to 11.5%) and otitis media (up to 4.7%).</p><p><strong>Conclusion: </strong>Comprehensive counselling is key in obtaining informed consent, especially in cohorts with diabetes mellitus (DM) and hypertension where monitoring of glucose and blood pressure is recommended. Gastroprotection should be considered. Future focus is required to study short-term steroid AEs and raise awareness among prescribing clinicians and patients.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Assessment of Vestibular Function by Video Head Impulse Test and Vestibular-Evoked Myogenic Potential During Cisplatin-Based Chemoradiation.","authors":"Natsuki Takada, Hiroshi Okuda, Hirofumi Shibata, Natsuko Obara, Kenichi Mori, Kosuke Terazawa, Ryo Kawaura, Ryota Iinuma, Rina Kato, Tatsuhiko Yamada, Takuro Tsunoki, Chiyoko Makita, Takayuki Mori, Takenori Ogawa","doi":"10.1111/coa.14335","DOIUrl":"https://doi.org/10.1111/coa.14335","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to determine the effects of cisplatin on vestibular function.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>We measured vestibulo-ocular reflex gain (VOR gain), cervical vestibular-evoked myogenic potential amplitude (cVEMP amplitude) and hearing acuity before and after treatment in 28 patients treated with cisplatin-based chemoradiation to determine changes in hearing and vestibular function.</p><p><strong>Results: </strong>VOR gain did not decrease significantly before and after treatment, but cVEMP amplitude decreased significantly (p < 0.01). Air and bone hearing level worsened significantly (p < 0.01). The VOR gain in the group receiving more than 200 mg/m² of cisplatin was significantly decreased compared with the group receiving less than 200 mg/m² (p < 0.05). The cVEMP amplitude and hearing level were not significantly different between the two groups. Even after adjusting for age and inner ear radiation dose, VOR gain was inversely related to increasing cisplatin dose (β = 0.19; SE = 0.08).</p><p><strong>Conclusions: </strong>Patients treated with cisplatin-based chemoradiotherapy exhibited decreased VOR gain. Patients should undergo vestibular and auditory testing before and after chemoradiation to detect potential vestibular impairment earlier, and prompt initiation of vestibular physical therapy would increase patients' quality of life.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Mortality in Necrotising Otitis Externa: The Charlson Comorbidity Index.","authors":"Dalton Barham, Stan Mckenzie, Glen Watson","doi":"10.1111/coa.14336","DOIUrl":"https://doi.org/10.1111/coa.14336","url":null,"abstract":"<p><strong>Introduction: </strong>Necrotising Otitis Externa (NOE) is a severe infection of the ear canal and skull base with a significant morbidity and mortality. There is a limited evidence base to help prognosticate in NOE, focused mainly on disease volume and associated damage. In this retrospective case series, we examined the potential use of the Charlson comorbidity index (CCI) in patients with confirmed NOE to determine its potential use as an additional prognostic indicator.</p><p><strong>Methods: </strong>Retrospective cohort analysis of 87 patients diagnosed with NOE over a 6-year period at a tertiary centre. We calculated the CCI for these patients and collected mortality data at 1 year. A logistic regression was used to analyse the data.</p><p><strong>Results: </strong>The mean CCI was 5.9. A higher score was a reliable indicator of 1-year mortality for patients with NOE with an odds ratio of 1.34 (p = 0.028).</p><p><strong>Conclusion: </strong>The CCI can be considered as a potential adjunct in patients presenting with NOE to guide prognostication and inform decision-making with patients.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on 'Comparison of White Light With Narrow Band Imaging Using Flexible Laryngoscopy for the Detection of Local Recurrences After (Chemo)Radiation for Pharyngeal or Laryngeal Cancer: A Randomised Controlled Trial'.","authors":"Francesca Boscolo Nata, Giancarlo Tirelli","doi":"10.1111/coa.14337","DOIUrl":"https://doi.org/10.1111/coa.14337","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cochlear Implantation in Australia: A Retrospective Analysis of 23 Years of Activity.","authors":"Robert H Eikelboom, Catherine M Sucher, Sandra R Bellekom, Marcus D Atlas","doi":"10.1111/coa.14334","DOIUrl":"https://doi.org/10.1111/coa.14334","url":null,"abstract":"<p><strong>Objectives: </strong>To report the number of cochlear implantation procedures and recipients in Australia since 2000 by age, and to estimate the adult uptake of cochlear implants.</p><p><strong>Methods: </strong>This was a retrospective analysis of data, using publicly available data on private and public hospital procedures undertaken in Australia between 2000/01 and 2022/23. The main outcome measures were: (i) Number of cochlear implants per financial year, by paediatric, adult, or 10-year age groups, and population adjusted. (ii) Adult uptake rate of cochlear implants, adjusted for explantation and replantation rates, and bilateral implantation rates. This study followed STROBE guidelines for reporting.</p><p><strong>Results: </strong>25 611 devices were implanted between July 2000 and June 2023, with annual numbers rising from 200 per year to over 1400 per year. Despite females having a 50% lower prevalence of hearing loss than males, approximately an equal number of males and females are implanted. Paediatric implantation has declined since 2016. The adult uptake rate of cochlear implants is estimated to be 10.5%.</p><p><strong>Conclusions: </strong>Despite the known economic and social benefits of cochlear implants, and the rising number of people with hearing loss, the initial increase in rates of implantation appeared to have slowed, and the uptake rate remains low. Public health and hospital policy should be directed to improving public education, awareness, and referral and assessment pathways, especially for males.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Initial Management of Paediatric Acute Rhinosinusitis With Orbital Complications Predict Future Outcomes? A Cohort Study.","authors":"Elchanan Zloczower, Itay Pansky, Batel Lasry, Aviad Sapir, Michael Samin, Itai Hazan, Lior Freidrich, Ofer Gluck, Oded Cohen, Oren Ziv","doi":"10.1111/coa.14329","DOIUrl":"https://doi.org/10.1111/coa.14329","url":null,"abstract":"<p><strong>Background: </strong>Approximately 6%-8% of children diagnosed with acute rhinosinusitis (ARS) would experience complications, primarily periorbital or orbital complications (OC). Both conservative and surgical management have been shown to be successful, and the choice of proper management depends on the presentation and the surgeon's discretion. The objective of this study was to describe the long-term outcomes of each modality on future ARS episodes, with or without OC.</p><p><strong>Methods: </strong>This retrospective study included patients < 16 years old with OC-ARS admitted to a tertiary hospital from 2002 to 2019. Patients were divided into groups based on treatment: conservative and surgical. Outcomes measured included recurrence of ARS, OC-ARS and future hospitalisations or surgeries due to ARS over a 5-year follow-up period.</p><p><strong>Results: </strong>Among 213 children diagnosed with OC-ARS, 192 (90.1%) were treated conservatively and 21 (9.9%) surgically. Most surgeries were performed endoscopically (16/21, 76.2%). Surgically treated children were older and had significantly higher rates of proptosis, impaired eye movement and higher Chandler scores at presentation (p = 0.034, p < 0.001, p < 0.001, p < 0.001, respectively). Overall, recurrent ARS rates were 10.3%, with significantly higher rates in the surgical group compared with the conservative group (28.6% vs. 8.3%, p = 0.012). While the surgical group did not have a significantly shorter interval to recurrence compared with the conservative group (8 vs. 15 months, p = 0.8), a significant risk reduction over time was observed (OR 6.22 and 3.71 after 1 and 5 years, respectively, p < 0.005).</p><p><strong>Conclusion: </strong>Most children with OC-ARS recover fully without future sequela. However, children that needed surgical treatment during the acute phase of OC-ARS, are at greater risk for future ARS episodes, particularly within the first-year post-surgery.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Non-Negligible Role of Benign Paroxysmal Positional Vertigo in Paediatric Vertigo: A Systematic Review and Meta-Analysis.","authors":"Jing Zhang, Jing Guan, Hongyang Wang, Jiao Zhang, Dayong Wang, Dong Yang, Huifang Zhou, Qiuju Wang","doi":"10.1111/coa.14323","DOIUrl":"https://doi.org/10.1111/coa.14323","url":null,"abstract":"<p><strong>Objective: </strong>Benign paroxysmal positional vertigo is a common cause of vertigo in adults but has been studied less extensively in children. Interestingly, the reported diagnostic frequency of benign paroxysmal positional vertigo in paediatric vertigo showed high variability. This systematic review and meta-analysis aimed to evaluate the proportion of benign paroxysmal positional vertigo in childhood vertigo and explore relevant factors to accurately diagnose BPPV in children.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Setting and participants: </strong>PubMed, EMBASE database and Cochrane library (from 1 January 1962, to 12 April 2022) were searched for eligible studies analysing the proportion of benign paroxysmal positional vertigo in children with vertigo. Only papers published in English were included.</p><p><strong>Main outcome measures: </strong>The pooled proportion of paediatric BPPV in childhood vertigo, and its corresponding 95% confidence interval (CI), were calculated. Additional subgroup analysis was performed by year of publication, testing techniques, department, regions, age and registering comorbidities of relevance for balance.</p><p><strong>Results: </strong>Ultimately, 26 studies were eligible for our meta-analysis. These studies involved 4043 childhood vertigo cases, of which 460 were BPPV. Based on the results of a random-effects model-based meta-analysis, the pooled proportion of benign paroxysmal positional vertigo in childhood vertigo was 5.5%. However, a subgroup analysis revealed a significantly higher pooled proportion of benign paroxysmal positional vertigo, with 9.9% in the videonystagmography subgroup and 17.1% in the comorbidity subgroup. Moreover, the proportion of BPPV varies among children with vertigo in different age groups.</p><p><strong>Conclusion: </strong>In conclusion, the pooled proportion of BPPV in vertigo children was 5.5% across all samples. The present study revealed that age, applying VNG in positional testing, and comorbidity diagnosis may be closely related to the diagnosis of BPPV in children. Additionally, to prevent missed diagnosis of benign paroxysmal positional vertigo, diagnostic BPPV tests should not be neglected in children suffering from other vertigo-associated diseases.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Promise and Challenges of 3D Bioprinting in Otolaryngology: A Contemporary Perspective Viewpoint.","authors":"Alfio Torrisi, Mario Lentini, Salvatore Pezzino, Caterina Gagliano, Salvatore Lavalle, Jerome Rene Lechien, Roberta Malaguarnera, Sergio Castorina, Filippo Torrisi, Antonino Maniaci","doi":"10.1111/coa.14333","DOIUrl":"https://doi.org/10.1111/coa.14333","url":null,"abstract":"<p><strong>Objectives: </strong>To conduct a critical review of the current applications, challenges and future directions of three-dimensional bioprinting (3DBP) in otolaryngology with a focus on surgical education, personalised implants and regenerative medicine.</p><p><strong>Design: </strong>Expert opinion based on a targeted literature review and clinical experience.</p><p><strong>Setting: </strong>Translational research relevance of academic otolaryngology.</p><p><strong>Main outcome measures: </strong>Assessment of bioprinting approaches and new materials, anatomical accuracy, overcoming limitations by pairing with enhanced technology as virtual and augmented reality.</p><p><strong>Results: </strong>3DBP is fast becoming an asset to otolaryngology. These stereolithography (SLA) models facilitate the use of high-fidelity temporal bone models for surgical simulation and training. Functional outcomes of patient-specific implants for ossiculoplasty and cochlear implantation are promising, albeit mostly in preclinical settings. Educators have turned to virtual and augmented reality platforms to improve classroom experiences. But significant hurdles remain, including biocompatibility, the cost of high-resolution technologies and regulatory impediments to clinical translation.</p><p><strong>Conclusion: </strong>Numerous studies have reported on the transformative potential of 3DBP for surgical planning, education implementation of personalised treatment in otolaryngology. A balanced assessment of both its current limitations and future promise is essential for ethical integration. The translation of this technology into routine practice will require multidisciplinary collaboration and rigorous validation through clinical trials.</p><p><strong>Level of evidence: </strong>V.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Team Otology Clinics Dedicated to Adult Patients With Learning Disabilities and/or Autism Spectrum Disorder: A Quality Improvement Project.","authors":"Aaron Hundle, Sue Atkins, Sophie McAnenny, Nasir Rashid, Claudia Lucy Dalton","doi":"10.1111/coa.14320","DOIUrl":"https://doi.org/10.1111/coa.14320","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Thyroid Gland Flap for the Management of Pexy Disruption Following Salvage Supracricoid Partial Laryngectomy After Radiation Failure.","authors":"Younghac Kim, Woori Park, HeeJung Kim, Nayeon Choi, Man Ki Chung, Han-Sin Jeong, Young-Ik Son","doi":"10.1111/coa.14328","DOIUrl":"https://doi.org/10.1111/coa.14328","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}