Clinical Otolaryngology最新文献

{"title":"Yield of Hearing Loss Gene Panel and Audiometric Findings in a Retrospective Cohort of Children With Permanent Childhood Hearing Impairment.","authors":"Alpana M Kulkarni, Henna Majeithia, Louise Busby","doi":"10.1111/coa.14316","DOIUrl":"https://doi.org/10.1111/coa.14316","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794756","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":"Utilisation of Near Infrared Autofluorescence in Parathyroid Identification During Thyroidectomy: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.","authors":"Azfar Javed, Abdullah Alburaiki, Neil Sharma, Mriganka De, George Garas, Ijaz Ahmad, Paul Nankivell, Anita Sonsale, Jonathan Fussey, Keshav Kumar Gupta","doi":"10.1111/coa.14313","DOIUrl":"https://doi.org/10.1111/coa.14313","url":null,"abstract":"<p><strong>Objective: </strong>Unintentional parathyroid gland resection during total thyroidectomy can result in permanent hypoparathyroidism and lifelong replacement therapy. Near infrared autofluorescence (NIRAF) imaging may aid intraoperative identification and preservation of the parathyroid glands. This article aims to review NIRAF's effectiveness in the prevention of post-operative hypoparathyroidism.</p><p><strong>Design: </strong>Systematic review and meta-analysis reported according to PRISMA guidelines.</p><p><strong>Methods: </strong>The electronic databases of MEDLINE, Embase and Cochrane were searched in September 2024. Included articles were randomised controlled trials (RCTs) that studied the use of NIRAF vs. dissection with no intraoperative aids in thyroidectomy. Meta-analysis was performed using a random-effects model. Primary outcomes were postoperative hypocalcaemia and permanent hypoparathyroidism.</p><p><strong>Results: </strong>Eight RCTs were included in the final analysis, comprising 1620 patients. Meta-analysis revealed patients undergoing thyroidectomy using NIRAF had a reduced risk of both post-operative hypocalcaemia (OR 0.56, 95% CI: 0.36-0.89, p = 0.01) and persistent hypoparathyroidism (OR 0.44, 95% CI: 0.22-0.89, p = 0.02).</p><p><strong>Conclusions: </strong>NIRAF use in thyroidectomy reduces the risk of post-operative hypocalcaemia and post-operative hypoparathyroidism.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788047","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":"Quality of Life and Sleep Outcomes in Obstructive Sleep Apnoea Following Transoral Robotic Surgery: A Meta-Analysis.","authors":"Keshav Kumar Gupta, Mriganka De, Thanos Athanasiou, Christos Georgalas, George Garas","doi":"10.1111/coa.14311","DOIUrl":"https://doi.org/10.1111/coa.14311","url":null,"abstract":"<p><strong>Objective: </strong>Obstructive sleep apnoea (OSA) can have a significant health burden in terms of sleep outcomes, systemic morbidity including cardiovascular and urological complications, and quality of life (QoL). Transoral robotic surgery (TORS) constitutes a novel option for patients where continuous positive airway pressure (CPAP) is not tolerated. This study aimed to assess OSA patients managed with TORS in terms of QoL and sleep outcomes.</p><p><strong>Data sources: </strong>Systematic review using EMBASE, CINAHL, MEDLINE, and Cochrane electronic databases.</p><p><strong>Review methods: </strong>Studies were identified assessing QoL (with validated QoL tools) and sleep outcomes in OSA patients managed with TORS. For the meta-analysis, mean difference (MD) was calculated using an inverse variance random-effects model.</p><p><strong>Results: </strong>Four studies (252 patients) were included. Meta-analysis showed improvements in apnoea-hypopnea index (AHI) (MD = 20.01, p < 0.00001), Epworth Sleepiness Scale (ESS) (MD = 5.16, p < 0.00001) and lowest oxygen saturations (LSaO₂) (MD = -7.05, p < 0.00001) following TORS. For QoL, there were improvements in voice, prostate and overactive bladder symptoms, erectile function, and overall QoL following TORS. Swallowing returned to baseline at 3 months. No major complications were reported, with all adverse events managed conservatively.</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis is the first in the existing literature to evaluate TORS as a treatment option for OSA across both sleep and QoL domains. Significant improvements were observed in both parameters following TORS. Whilst further research is needed, the current findings can assist clinicians and patients when it comes to clinical decision-making regarding personalised treatment options for a condition that carries a significant morbidity and QoL burden.</p><p><strong>Trial registration: </strong>PROSPERO: CRD42024448926.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763271","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":"Validation of the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q) for Use in Chronic Rhinosinusitis.","authors":"Marc C den Heijer, Gonneke E Joustra, Karin M Vermeulen, Astrid G W Korsten-Meijer, Robert A Feijen","doi":"10.1111/coa.14306","DOIUrl":"https://doi.org/10.1111/coa.14306","url":null,"abstract":"<p><strong>Objectives: </strong>The Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q) is the only known instrument designed to assess Health-Related Quality of Life (HRQoL) in chronic rhinosinusitis (CRS) across all three health domains: physical, social, and psychological. Initially, the EES-Q was validated to evaluate the impact of endoscopic endonasal surgery (EES) on HRQoL. Our goal is to use the EES-Q for all CRS patients, regardless of their treatment phase. Previously, we demonstrated a significantly worse HRQoL in tertiary CRS patients compared to healthy individuals. The aim of this study is to validate these findings in a secondary referral cohort distributed across multiple centres, thereby extending the applicability of the EES-Q to all CRS patients.</p><p><strong>Design: </strong>Multicentre know-groups validity study.</p><p><strong>Setting: </strong>Five secondary referral hospitals and one tertiary referral centre.</p><p><strong>Participants: </strong>A total of 100 healthy control subjects without any history of sinusitis or current hospital-based medical treatment, 100 CRS patients from a secondary centre with no history of EES, and 100 CRS patients from a tertiary centre were included.</p><p><strong>Main outcome measures: </strong>Mann-Whitney U test was performed to identify differences in domain scores and EES-Q scores between the different cohorts.</p><p><strong>Results: </strong>The median EES-Q scores, as well as the physical, psychological, and social domain scores, were significantly higher in the secondary and tertiary cohorts compared to the healthy controls. No significant differences were observed between the secondary and tertiary cohorts.</p><p><strong>Conclusion: </strong>We validated the EES-Q as an HRQoL instrument for use in CRS.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751320","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":"Paediatric Acute Invasive Fungal Sinusitis Outcomes Over a 13-Year Period.","authors":"Matthew James Wu, Marie-Ange Munyemana, Lauren Roland","doi":"10.1111/coa.14310","DOIUrl":"https://doi.org/10.1111/coa.14310","url":null,"abstract":"<p><strong>Objectives: </strong>To identify prognostic factors of paediatric acute invasive fungal sinusitis (AIFS) patients.</p><p><strong>Design: </strong>Weighted cross-sectional analysis over 13-year period (2006-2019).</p><p><strong>Setting: </strong>Public national hospitalisation database.</p><p><strong>Participants: </strong>Immunocompromised paediatric (age < 21 years) patients with sinonasal fungal infection who underwent sinonasal surgical treatment.</p><p><strong>Main outcome measures: </strong>Clinical characteristics (e.g., medical comorbidities, fungal species, age), mortality rate.</p><p><strong>Statistical analysis: </strong>To compare mortality rates, the Fisher's exact test was used for individual conditions, each fungal species, and hospital treatment setting. The sample's median age (12 years) divided patients into younger and older groups. For two-sided tests, a p value of < 0.05 was considered significant. A Bonferroni correction was applied to evaluate fungal species and mortality, where a p value < 0.0167 was considered significant.</p><p><strong>Results: </strong>A weighted total of 408 surgically treated AIFS patients were identified (median age 12 years). The most common immunocompromised comorbidities were neoplasms (75.7%) and hematologic disorders (71.2%). The most common fungal species were \"other unspecified mycoses\" as defined by ICD codes (53.8%) then mucormycoses (35%). The overall mortality rate was 16.1%. The only immunocompromised comorbidity associated with increased mortality was immunodeficiency disorders (25.3%; p = 0.023). Demographics associated with increased mortality were being male (12.3% vs. 3.9%; p = 0.004), but not older age (56.1% vs. 43.9%; p = 0.588). Patients with aspergillosis infections had increased mortality (26.2%; p = 0.003), but not other fungal species.</p><p><strong>Conclusion: </strong>In the largest national sample of paediatric AIFS patients, the overall mortality rate was 16.1%. Negative prognostic indicators included male sex, immunodeficiency disorder, and aspergillosis infections.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728940","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":"Association Between Ménière's Disease and Thyroid Disease: A Systematic Review and Meta-Analysis.","authors":"Rui Lai, Liwen Tang, Tingting Zhu, Qiang Li","doi":"10.1111/coa.14308","DOIUrl":"https://doi.org/10.1111/coa.14308","url":null,"abstract":"<p><strong>Objectives: </strong>The relationship between thyroid disease and Ménière's disease (MD) remains controversial. This article aims to explore the association between thyroid disease and MD and provide new evidence for the prevention and treatment of MD and its complications.</p><p><strong>Design: </strong>A systematic review and meta-analysis.</p><p><strong>Methods: </strong>PubMed, EMBASE, Web of Science and Cochrane Library were searched until July 08, 2024. Based on the eligibility criteria, the literature was screened, the data were extracted, and the study quality was evaluated. The prevalence and/or incidence of MD in thyroid disease and the prevalence and/or incidence of thyroid disease in MD were explored. The pooled proportion with 95% confidence interval (CI) was calculated using a random-effects model.</p><p><strong>Results: </strong>Eighteen eligible studies were finally enrolled. A total of 14 studies mentioned the prevalence of thyroid disease in MD, with a pooled prevalence rate of 8%. Two studies reported the prevalence of MD in thyroid patients, with a pooled prevalence rate of 22%. Four studies explored the incidence of thyroid disease in MD, with a combined incidence rate of 23%. Thyroid hormone treatment not only improved hypothyroidism symptoms but also MD.</p><p><strong>Conclusions: </strong>There is a significant association between thyroid disease and MD. Symptoms of hypothyroidism and MD can be improved after thyroid hormone treatment. The available evidence is limited, and more prospective and high-quality studies are required for validation.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708919","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":"Versatility of Posteriorly Based Myomucosal Buccinator Flap for Reconstruction of Acquired Palatal Defects.","authors":"Ali Tawfik, Ahmed Musaad Abd El-Fattah, Hisham Atef Ebada","doi":"10.1111/coa.14309","DOIUrl":"https://doi.org/10.1111/coa.14309","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699890","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":"Techniques of Injection Laryngoplasty Under Local Anaesthesia in Unilateral Vocal Fold Paralysis: A Systematic Review.","authors":"Florent Carsuzaa, Solange Milhe de Saint Victor, Sabine Crestani, Aude Lagier, Florent Espitalier, Erwan de Mones","doi":"10.1111/coa.14307","DOIUrl":"https://doi.org/10.1111/coa.14307","url":null,"abstract":"<p><strong>Introduction: </strong>To compare the efficacy of vocal results and the occurrence of pulmonary complications of different techniques of injection laryngoplasty under local anaesthesia in unilateral vocal fold paralysis (UVFP).</p><p><strong>Methods: </strong>A systematic review of the literature was carried out and selected studies evaluating the efficacy and safety of transnasal, transoral, or transcutaneous injection laryngoplasty in iatrogenic, traumatic, tumoral, or idiopathic UVFP. The equation [(unilateral) AND ((vocal fold) OR (laryngeal) OR (vocal cord)) AND ((injection) OR (laryngoplasty)) AND ((office) OR (in-office) OR (local) OR (outpatient))] was used in an analysis of the literature over a period from 1995 to 2022.</p><p><strong>Results: </strong>Seventeen articles were retained for the final analysis. Among the 634 patients having undergone a single technique of injection laryngoplasty under local anaesthesia, 27 patients (4%) had medialisation by injection by transnasal route, 103 (17%) by transoral route, and 504 (79%) by transcutaneous route. Among the 278 patients having undergone analysis of maximum phonation time, an improvement of 4.57 ± 2.3 s was noted after the injection.</p><p><strong>Conclusion: </strong>Injection laryngoplasty under local anaesthesia of UVFP is a reliable and safe technique enabling improved voice quality. The different techniques lead to improved vocal results similar to those found under general anaesthesia.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699888","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 Artificial Intelligence Software be Utilised for Thyroid Multi-Disciplinary Team Outcomes?","authors":"Amir Habeeb, Kim Hui Lim, Xenofon Kochilas, Nazir Bhat, Furrat Amen, Samuel Chan","doi":"10.1111/coa.14305","DOIUrl":"https://doi.org/10.1111/coa.14305","url":null,"abstract":"<p><strong>Objectives: </strong>ChatGPT is one of the most publicly available artificial intelligence (AI) softwares. Ear, nose and throat (ENT) services are often stretched due to the increasing incidence of thyroid malignancies. This study aims to investigate whether there is a role for AI software in providing accurate thyroid multidisciplinary team (MDT) outcomes.</p><p><strong>Methods: </strong>A retrospective study looking at unique thyroid MDT outcomes between October 2023 and May 2024. ChatGPT-4TM was used to generate outcomes based on the British Thyroid Association (BTA) Guidelines for Management of Thyroid Cancer. Concordance levels were collected and analysed.</p><p><strong>Results: </strong>Thirty thyroid cases with a mean age of 58 (n = 24 female, n = 6 male) were discussed. The MDT's outcome had a 100% concordance with BTA Guidelines. When comparing ChatGPT-4TM and our MDT the highest level of concordance Y1 was seen in 67% of case while 13% of cases were completely discordant.</p><p><strong>Conclusions/significance: </strong>AI is cheap, easy to use can optimise complex thyroid MDT decision making. This could free some clinicians allowing them to meet other demands of the ENT service. Some key issues are the inability to completely rely on the AI software for outcomes without being counterchecked by a clinician.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662959","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 Effect of Concomitant Septoplasty and Turbinate Surgery on Nasality-Related Voice Parameters.","authors":"Cevat Celenk, Burak Ulkumen, Onur Celik","doi":"10.1111/coa.14304","DOIUrl":"https://doi.org/10.1111/coa.14304","url":null,"abstract":"<p><strong>Introduction: </strong>Our study aimed to reveal whether septoplasty and inferior turbinate reduction significantly impact the acoustic properties of nasalized syllables and alter subjective and objective voice parameters.</p><p><strong>Materials and methods: </strong>Forty patients with nasal septal deviation and bilateral grade 2 ≤ inferior turbinate hypertrophy who underwent septoplasty and bilateral inferior turbinoplasty were enrolled. Participants completed the VHI-10, VAS, and NOSE scales preoperatively and at 6 months postoperatively. Changes in VAS and NOSE scores were calculated as VAS^change and NOSE^change values. Voice recordings of the sustained vowel /a/ and the word /mini/ were analysed using MDVP. Acoustic analysis was performed with the sustained vowel /a/, and spectrographic analysis was conducted with the consonants /m/, /n/, and the vowel /i/ in /mini/. Recordings were taken preoperatively and at 6 months postoperatively. Statistical analysis compared pre- and postoperative values for significant changes using SPSS Version 21.0 (IBM Corp.; Armonk, NY, USA).</p><p><strong>Results: </strong>A statistically significant decrease in VAS and NOSE scores was observed at 6 months postoperatively (p < 0.05). No significant difference was found in VHI-10 scores (p > 0.05). Acoustic analysis showed a significant change in pre- and postoperative F0 values (p < 0.05), but not in jitter, jitter%, shimmer, shimmer%, and NHR (p > 0.05). Spectrographic analysis revealed significant postoperative changes in the F3 and F4 formants of consonants /m/, /n/, and vowel /i/ in the word /mini/. A significant correlation was found between postoperative changes in F3 and F4 formant values for consonants /m/ and /n/ with the VAS^change value. For the NOSE^change value, a significant correlation was found only with the change in the F3 formant value for the consonant /m/.</p><p><strong>Conclusion: </strong>Nasal surgeries, particularly septo-turbinoplasty, can influence voice timbre by modifying F3 and F4, which is of notable concern for professional voice users, such as singers and actors, due to the potential impact on the singer's formant cluster and overall vocal quality. Although it may not be appropriate to generalise for all rhinological surgeries, the significant changes in the F3 and F4 formants in a specific and refined patient group suggest that caution should be exercised in such surgeries, especially for professional voice users.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656241","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}