Clinical Otolaryngology最新文献

{"title":"Treatment Outcomes of Intralesional Steroid Injection for Refractory Vocal Process Granuloma","authors":"Po-Jun Yu,&nbsp;Wei-Chen Hung,&nbsp;Chi-Te Wang","doi":"10.1111/coa.14210","DOIUrl":"10.1111/coa.14210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Vocal process granuloma (VPG) is a chronic condition resulting from a mucoperichondrial injury of vocal process. Initial conservative treatment typically involves vocal hygiene education and antireflux medication. Treatment challenges arise with refractory cases. Outcomes of second-line treatments such as surgical excision and botulinum toxin injections remain inconsistent. Thus, we propose this study to investigate the effectiveness of intralesional steroid injections for refractory VPG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective review of 23 patients with VPG who showed no improvement after 3 months of proton pump inhibitors. These patients underwent one to three courses of monthly in-office intralesional steroid injections as a second-line therapy. Treatment outcomes were evaluated by measuring the size of the VPG relative to the length of the vocal folds before and after the final injection procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results showed a significant reduction in VPG size from baseline of 27.74 ± 15.06 to 5.48 ± 8.95 (p &lt; .001). 15 out of 23 patients were responsive (size reduction ≥ 75%) to intralesional steroid injection. Alcohol consumption and longer symptom duration were associated with a poor response (size reduction &lt;75%), whereas prior intubation was associated with better response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For refractory VPG not responding to conservative treatment, intralesional steroid injection appears to be a promising alternative option without significant adverse effects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"822-826"},"PeriodicalIF":1.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970802","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":"Intraoperative Detection of Extracochlear Electrodes Using Stimulation Current Induced Non-Stimulating Electrode Voltage (SCINSEV) Measures (Transimpedance Measures)—A Case Series","authors":"Muhammed Ayas,&nbsp;Yu Chuen Tam,&nbsp;Dakota Bysouth-Young,&nbsp;Susan T. Eitutis,&nbsp;Marina Salorio-Corbetto,&nbsp;Patrick R. Axon,&nbsp;Neil P. Donnelly,&nbsp;James R. Tysome,&nbsp;Daniele Borsetto,&nbsp;Mathew E. Smith,&nbsp;Manohar L. Bance","doi":"10.1111/coa.14212","DOIUrl":"10.1111/coa.14212","url":null,"abstract":"&lt;p&gt;Cochlear implants (CIs) are prosthetic devices used to restore hearing sensation in people with severe to profound sensorineural hearing loss [&lt;span&gt;1&lt;/span&gt;]. The success of the CI surgery relies on the surgical placement of the electrodes within the scala tympani. Electrode migration post placement is well documented and could significantly affect the overall CI performance [&lt;span&gt;2&lt;/span&gt;]. Migration may result in extracochlear electrodes (EE). Notably, this is under-reported in the existing literature [&lt;span&gt;3, 4&lt;/span&gt;]. Routine intraoperative measures, such as contact impedances, may not indicate misplacement or extrusion of electrodes, particularly if there is an electrically conductive blood, fluid, or soft tissue around the EEs, which may result in the normal contact impedances. If the EE are in air, the contact impedances will show an open circuit and so are easier to detect [&lt;span&gt;5, 6&lt;/span&gt;]. Advanced measures such as the stimulation current induced non-stimulating electrode voltage (SCINSEV- termed differently in various clinical software as transimpedance matrix (TIM) by Cochlear Corp, electric field imaging (EFI) by Advanced Bionics(AB) and impedance field telemetry (IFT) by MEDEL), could potentially be used to detect the extrusion EE. The application of SCINSEV measurements in cadaveric studies demonstrates a comparable and well-defined role in the identification of electrode EE, as detailed in the existing literature [&lt;span&gt;5, 6&lt;/span&gt;]. Here, we report three cases of intraoperative electrode extrusion detected using SCINSEV measures, subsequently performing corrective repositioning during the same surgical session which prevented the need for delayed revision surgery. This report further highlights the potential of SCINSEV as an important tool in intraoperative measures and enhancing CI surgical outcomes and reports for the first time their use in live patient surgery as determinants of EE and for intraoperative decision-making and correction.&lt;/p&gt;&lt;p&gt;Three paediatric patients are reported, implanted either bilaterally or unilaterally on the basis of multidisciplinary team decisions. All the 3 patients were females, with a mean age of 11 ± 3 years (Table 1). Preoperative magnetic resonance imaging (MRI) was performed to evaluate cochlear anatomical structures and assess the integrity of the auditory nerve. All the patients were implanted with AB HiRes Ultra 3D implants using the round window approach. After periosteal closure, intraoperative electrical impedance and other measurements were performed.&lt;/p&gt;&lt;p&gt;In our centre, the intraoperative test protocol follows a battery of tests including initial contact impedance measures, subsequent SCINSEV (termed EFI by AB) and Electrical Compound Action Potentials (ECAP). Following CI placement in the subperiosteal pocket and electrode insertion, the external coil is attached underneath the sterile surgical drapes and connected to a AB-AIM (active insertion monitoring) tablet system, and","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"827-832"},"PeriodicalIF":1.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Auscultation for Detecting Oropharyngeal Aspiration in Paediatric and Adult Populations: A Systematic Review and Meta-Analysis","authors":"Annelise C. Cron,&nbsp;Michael David,&nbsp;Jane Orbell-Smith,&nbsp;Anne B. Chang,&nbsp;Kelly A. Weir,&nbsp;Thuy T. Frakking","doi":"10.1111/coa.14202","DOIUrl":"10.1111/coa.14202","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cervical auscultation (CA) involves listening to swallowing and respiratory sounds and/or vibrations to detect oropharyngeal aspiration (OPA). CA has shown promising diagnostic test accuracy when used with the clinical swallowing examination and is gaining popularity in clinical practise. There has not been a review to date analysing the accuracy of CA in paediatric and adult populations with meta-analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the accuracy of CA in detecting OPA in paediatric and adult populations, when compared to instrumental assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Methods</h3>\u0000 \u0000 <p>Databases searched included MEDLINE, PubMed, Embase, CINAHL, AustHealth, Cochrane and Web of Science. The search was restricted between 01 October 2012 and 01 October 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>Inclusion criteria included (a) all clinical populations of all ages, (b) who have had an instrumental assessment and (c) CA. All study types were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Studies were reviewed independently by two authors. The methodological quality of the studies was analysed using the QUADAS-2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>Ten studies met the inclusion criteria for this review and meta-analyses. The pooled diagnostic performance of CA in detecting OPA was 0.91 for sensitivity and 0.79 for specificity. The area under the curve summary receiver operating curve (sROC) was estimated to be 0.86, thereby indicating good discrimination of OPA. Most studies scored high for risk of bias in at least one domain in the QUADAS-2, likely attributed to a lack of high-quality prospectively designed studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There are promising diagnostic test accuracies for the use of CA in detection of OPA. Future research could include using CA in specific clinical populations and settings, and identifying standardised criteria for CA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"713-724"},"PeriodicalIF":1.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimum Fascia-Tumour Distance for Differentiating Deep Lobe From Superficial Lobe Benign Parotid Tumours: A Retrospective Study and Meta-Analysis","authors":"Yi-Chan Lee,&nbsp;Yao-Te Tsai,&nbsp;Ming-Shao Tsai,&nbsp;Ti-Yung Tseng,&nbsp;Chih-Chen Chang,&nbsp;Kai-Ping Chang","doi":"10.1111/coa.14207","DOIUrl":"10.1111/coa.14207","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study was designed to evaluate the diagnostic efficacy of the minimum fascia-tumour distance (MFTD) in distinguishing deep-lobe benign parotid tumours from superficial-lobe tumours through both an original study and a meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, we performed a retrospective analysis of data from 91 patients who had been diagnosed with benign parotid tumours. The MFTD values were sourced from preoperative ultrasound examinations. The locations of these tumours were confirmed through surgical findings. We assessed the diagnostic accuracy of MFTD by utilising receiver operating characteristic (ROC) curves. Additionally, we conducted a systematic review of the pertinent literature and performed a diagnostic meta-analysis to ascertain the overall diagnostic efficacy of MFTD in identifying benign parotid tumours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with tumours in the deep lobe had a significantly greater MFTD than patients with tumours in the superficial lobe. Using a cutoff value of 3.50 mm for MFTD, we found an AUC of 0.93, a sensitivity of 81.8%, and a specificity of 98.8%. Our meta-analysis included seven studies covering a total of 1689 tumours. The pooled values for sensitivity, specificity, and diagnostic odds ratio (OR) of MFTD were 81.0%, 89.0%, and 32.2, respectively. The AUC of the summarised ROC curve of MFTD was 0.90.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The MFTD demonstrated reliable diagnostic accuracy in identifying deep-lobe benign parotid tumours and may be incorporated into standard evaluations before parotidectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"785-792"},"PeriodicalIF":1.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901150","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":"Gender-Related Aspects of Laryngeal Squamous Cell Carcinoma: A Retrospective Cohort Study","authors":"Nir Tsur,&nbsp;Elchanan Zloczower,&nbsp;Michal Tunik,&nbsp;Ido Amir,&nbsp;Eyal Yosefof,&nbsp;Hagit Shoffel Havakuk,&nbsp;Yaniv Hamzany,&nbsp;Noga Kurman","doi":"10.1111/coa.14206","DOIUrl":"10.1111/coa.14206","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Laryngeal squamous cell carcinoma (SCC) is a predominantly male illness. Although the rate of female patients increased, a knowledge gap exists in the medical literature regarding gender-based differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Adult patients treated for laryngeal SCC in a tertiary medical centre between 2006 and 2020. Data were collected on demographics, clinical presentation, treatment modalities, disease recurrence and survival status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Two hundred ninety-one patients with laryngeal SCC, 50 (17.2%) females and 241 (82.8%) males.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Disease-specific survival (DSS), overall survival (OS) and disease-free survival (DFS), as well as differences in disease characteristics and treatment modalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tumour subsites differed significantly between females and males (36% vs. 19.5% supraglottic, 62% vs. 80.5% glottic and 2% vs. 0% subglottic, respectively; <i>p</i> = 0.006). Females were diagnosed at younger ages (61.7 ± 10.58 vs. 65.87 ± 11.11 years, <i>p</i> = 0.016) and advanced-stage disease (58% vs. 39.4%, <i>p</i> = 0.018). Females were treated with combined modalities at higher rates (36% vs. 54.8% for single modality, <i>p</i> = 0.031). DSS rates did not differ between genders (log-rank <i>p</i> = 0.12). Despite being diagnosed at more advanced disease stages, females demonstrated prolonged median OS compared to males (130.17 vs. 106.17 months, log-rank <i>p</i> = 0.017). No significant differences in DFS were observed (log-rank <i>p</i> = 0.32). In a multivariate Cox proportional hazards model, male gender remained an independent negative OS predictor (HR = 2.08; CI, 1.10–3.96; <i>p</i> = 0.025), along with increasing age (HR = 1.06; CI, 1.04–1.09; <i>p</i> &lt; 0.001) and advanced disease stage (HR = 1.7; CI, 1.08–2.67; <i>p</i> = 0.023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest the importance of considering gender-specific factors in the management of laryngeal SCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"765-775"},"PeriodicalIF":1.7,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Model Predicts Postoperative Outcomes in Chronic Rhinosinusitis With Nasal Polyps","authors":"Anda Gata,&nbsp;Lajos Raduly,&nbsp;Liviuța Budișan,&nbsp;Adél Bajcsi,&nbsp;Teodora-Maria Ursu,&nbsp;Camelia Chira,&nbsp;Laura Dioșan,&nbsp;Ioana Berindan-Neagoe,&nbsp;Silviu Albu","doi":"10.1111/coa.14208","DOIUrl":"10.1111/coa.14208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Evaluating the possibility of predicting chronic rhinosinusitis with nasal polyps (CRSwNP) disease course using Artificial Intelligence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We prospectively included patients undergoing first endoscopic sinus surgery (ESS) for nasal polyposis. Preoperative (demographic data, blood eosinophiles, endoscopy, Lund-Mackay, SNOT-22 and depression PHQ scores) and follow-up data was standardly collected. Outcome measures included SNOT-22, PHQ-9 and endoscopy perioperative sinus endoscopy (POSE) scores and two different microRNAs (miR-125b, miR-203a-3p) from polyp tissue. Based on POSE score, three labels were created (controlled: 0–7; partial control: 8–15; or relapse: 16–32). Patients were divided into train and test groups and using Random Forest, we developed algorithms for predicting ESS related outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Based on data collected from 85 patients, the proposed Machine Learning-approach predicted whether the patient would present control, partial control or relapse of nasal polyposis at 18 months following ESS. The algorithm predicted ESS outcomes with an accuracy between 69.23% (for non-invasive input parameters) and 84.62% (when microRNAs were also included). Additionally, miR-125b significantly improved the algorithm's accuracy and ranked as one of the most important algorithm variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We propose a Machine Learning algorithm which could change the prediction of disease course in CRSwNP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"776-784"},"PeriodicalIF":1.7,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Effects of Optokinetic Stimuli and Dual-Task Performance on Vestibulo-Ocular Reflex Function in Children With Attention Deficit and Hyperactivity Disorder","authors":"Hanifi Korkmaz,&nbsp;Emine Aydin,&nbsp;Fatma Ceyda Akin Ocal,&nbsp;Bulent Satar","doi":"10.1111/coa.14201","DOIUrl":"10.1111/coa.14201","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study investigated the effects of optokinetic stimuli and dual-task performance on vestibulo-ocular reflex (VOR) function. The study primarily focused on understanding the effects of attention deficit and hyperactivity disorder (ADHD) and its subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>A case–control study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Tertiary medical centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-eight children diagnosed with ADHD and 40 typically developing (TD) children aged 8–18 were included in the study. According to their diagnostic reports, children diagnosed with ADHD were also examined in three subtypes: predominantly inattentive (ADHD-PI), predominantly hyperactive–impulsive (ADHD-HI) and the combined type. Functional head impulse test (fHIT) was applied to all participants in three conditions—with no additional stimulus, optokinetic stimulation and dual-task. Correct responses (CR) were determined for each group, and the conditions were compared. For the dual-task test performance, children were given a counting task.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings of the study are significant. The CR values obtained from the fHIT tests applied under three different conditions were lower in the ADHD group compared to the control group. CR values for all fHIT conditions and all semicircular canals were lower in the ADHD-PI subtype and higher in the ADHD-HI subtype compared to other subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study has significant practical implications underscoring its relevance. fHIT, when applied with different protocols, can provide valuable information about the vestibular and cognitive states of children with ADHD. These results are particularly significant as the diagnosis of ADHD often relies on subjective interpretations, and fHIT offers a more objective and reliable method of evaluation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"754-764"},"PeriodicalIF":1.7,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prognostic Value of Active Otitis Media on Tympanoplasty Success Rate—A Systematic Review","authors":"Hanae Fumiyo Namba,&nbsp;Mariëlle Bernadette Plug,&nbsp;Adriana Leni Smit","doi":"10.1111/coa.14205","DOIUrl":"10.1111/coa.14205","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim is to investigate the influence of an active otitis media on the success rate of tympanoplasty in patients with a chronic otitis media (COM) and a tympanic membrane perforation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Databases Reviewed</h3>\u0000 \u0000 <p>PubMed, Embase and the Cochrane Library.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The inclusion criteria were studies on closure rates of tympanoplasty performed in COM patients of any age with a tympanic membrane perforation caused by COM. The exclusion criteria were studies on patients undergoing concomitant mastoidectomy, ossicular chain reconstruction, tuboplasty, adenoidectomy, revision tympanoplasty, patients with perforations due to other conditions than COM, and letters to editors, commentaries, conference abstracts and case reports. The included articles were critically appraised using the QUIPS tool. Data on tympanic membrane closure rate were extracted, odds ratio (OR) and 95% confidence intervals (CI) of the closure rate with a wet versus a dry ear were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The search was performed on 1 February 2023. Of 4671 articles, 16 studies were included and critically appraised. Of these observational studies (nine prospective, seven retrospective), with a total of 1509 patients (dry ear group <i>n</i> = 1003; wet ear group <i>n</i> = 506), two studies stated a significant difference in success rate, one in favour of a dry ear and one in favour of a wet ear at time of surgery. All other studies did not show a statistically significant difference. Overall, the risk of bias was considered moderate to high.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found no significant prognostic value of having an active otitis media during tympanoplasty on tympanic membrane closure rates. Because the overall risk of bias was considered moderate to high, no strong conclusions can be made. To be able to answer this question with higher levels of evidence, high-quality prospective or randomized studies are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"699-712"},"PeriodicalIF":1.7,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Head Neck Squamous Cell Cancer From an Unknown Primary: Systematic Reviews and National Audit Outcome Data to Generate National Guidelines","authors":"Vinidh Paleri,&nbsp;John Hardman,&nbsp;Tom Roques,&nbsp;Ben O'Leary","doi":"10.1111/coa.14204","DOIUrl":"10.1111/coa.14204","url":null,"abstract":"&lt;p&gt;We take great pleasure in introducing this supplement dedicated to management of head neck squamous cell cancer from an unknown primary (HSCCUP).&lt;/p&gt;&lt;p&gt;The management of HNSCCUP is inherently difficult for several reasons. Firstly, there is a paucity of robust contemporary evidence on the topic. Historic studies predate our understanding of the role of human papillomavirus (HPV) in the head and neck and, with the incidence of HPV related disease rising, management recommendations should necessarily keep abreast of this evolving landscape to be able to offer the greatest certainty of any patient benefit. Secondly, the understanding and definition of what is considered an ‘unknown primary’ alters during the diagnostic pathway as examination, investigations and biopsies identify disease. As a result, direct interstudy comparisons or meta-analysis are complicated by incongruent cohort definitions and eligibility criteria. Thirdly, true unknown primary disease is not common (3%–5% of all head and neck cancers), and so establishing both a substantial evidence base and reasonable clinical experience regarding its management can be challenging, particularly in the single centre setting.&lt;/p&gt;&lt;p&gt;Despite these limitations, many organisations have produced guidelines covering the management of HNSCCUP, using a variety of methodologies. In considering which methodology to adopt to produce the present guidelines, the editors chose to develop a bespoke multi-stage process for several reasons. Firstly, owing to the paucity of contemporary evidence, consensus opinion will undoubtedly be controversial. Without a robust evidence base, consensus opinion would benefit from being as representative of all stakeholders as possible. This lends itself to as much multicentre national engagement as possible to encourage widespread buy-in to the output. Secondly, by involving as many stakeholders and centres as possible, the resultant guidelines are more likely to be considerate of local resource constraints, and so more likely to be adhered to.&lt;/p&gt;&lt;p&gt;We put in place an ambitious programme of work in consultation with several stakeholder organisations to realise this aim. The methodology for consensus generation was set out ahead of this exercise, and peer reviewed by an expert team to ensure critical feedback and generate stakeholder support [&lt;span&gt;1&lt;/span&gt;]. Consultation with a wide array of professional groups The Head and Neck Society | ENT UK, The British Society of Head &amp; Neck Imaging, The Royal College of Radiology ǀ Clinical Oncology section, and The Royal College of Speech and Language Therapists led to focused questions, the answers for which would inform unknown primary management. These led to the format for consensus day, which closely followed the patient journey. The data to inform consensus was generated from systematic reviews, national audits, prospective study [&lt;span&gt;2&lt;/span&gt;] and a Delphi exercise. Both national audits were led by INTEGRATE—The UK E","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"837-841"},"PeriodicalIF":1.7,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Tinnitus and Systemic Disease in Adolescents: Implications of Vitamin D Deficiency and Anaemia","authors":"Sang-Yoon Han,&nbsp;Young Ho Kim","doi":"10.1111/coa.14203","DOIUrl":"10.1111/coa.14203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Tinnitus is one of the irritating symptoms that should be addressed in adolescents. Since tinnitus affects mental health, it is important to treat it. However, identifying the cause of tinnitus is very challenging and the treatment strategies of tinnitus are controversial. The objective of this study was to identify the prevalence of tinnitus in adolescents and systemic diseases as risk factors of adolescent tinnitus to find evidence for new treatment strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We extracted the subjects and data using the 5th Korea National Health and Nutrition Examination Survey from 2010 to 2012. One thousand five hundred ninety-three adolescents with bilateral normal tympanic membranes and availability of the results of physical, laboratory and audiological examinations, were selected. We evaluated their systemic diseases based on these results and assessed the association of tinnitus with demographic factors, systemic diseases and hearing levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of tinnitus in Korean adolescents was 21.7%. The hearing level was not associated with tinnitus. Tinnitus was significantly associated with age (<i>p</i> = 0.005), 25(OH)-D level (<i>p</i> = 0.007) and anaemia (<i>p</i> = 0.003). After controlling the other factors, age (<i>p</i> = 0.045), 25(OH)-D level (<i>p</i> = 0.041) and anaemia (<i>p</i> = 0.019) were independently related to tinnitus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tinnitus in adolescents was significantly associated with age, vitamin D and anaemia. Physicians should consider the higher likelihood of these deficiencies or diseases in adolescent tinnitus patients. Additionally, recognizing these associations may be helpful in developing treatment strategies for adolescent tinnitus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"748-753"},"PeriodicalIF":1.7,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757529","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}