Clinical Otolaryngology最新文献

{"title":"Socioeconomic Inequality in the Head and Neck Cancer Referral System: Redressing the Balance","authors":"Sabrina Tengku,&nbsp;Aislinn FitzGerald,&nbsp;Alison E. Lim,&nbsp;Jenny Montgomery","doi":"10.1111/coa.14232","DOIUrl":"10.1111/coa.14232","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Socioeconomic deprivation is a known risk factor for head and neck cancer (HNC). Despite this, there is no current way to acknowledge this in two-week wait (2WW) referrals. 2WW HNC referrals have continually risen, and a self-reporting questionnaire was trialled with referrals to the ear, nose and throat (ENT) department with suspected HNC, allowing additional triage information not included in referrals to be obtained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients referred through the 2WW pathway for HNC between February 2021 and March 2022 were asked to complete an electronic self-reporting symptom questionnaire. The vetting process resulted in the referral being accepted or regraded to less urgent referral streams. Scottish Index of Multiple Deprivation (SIMD) quintiles were derived using the online postcode checker tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 984 2WW referrals were retrospectively reviewed. The questionnaire was completed by 717 (72.9%) patients. Regrading of urgency resulted in 292 (29.7%) 2WW appointments not required. Of those regraded, 264 (90.4%) patients completed the questionnaire. A significantly greater number of patients (<i>p</i> = 0.03) from SIMD 4 and SIMD 5 were regraded (33.3%) compared to SIMD 1 and SIMD 2 (26.4%). Patients who did not complete the questionnaire had a higher median age (61.0 years, range: 17–96, IQR: 25.0) compared to those who completed the questionnaire (56.0 years, range: 17–88, IQR: 23.5, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A self-reported symptom questionnaire can help rebalance urgent appointments to those with genuine red flag symptoms. This in turn reduces social inequality in 2WW referrals and reduces the number of inappropriate 2WW appointments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"68-74"},"PeriodicalIF":1.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342919","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":"Factors Associated With Persisting Olfactory Dysfunction After COVID-19","authors":"Bernhard Prem,&nbsp;David T. Liu,&nbsp;Katharina Boehme,&nbsp;Mia T. Maurer,&nbsp;Bertold Renner,&nbsp;Christian A. Mueller","doi":"10.1111/coa.14233","DOIUrl":"10.1111/coa.14233","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fortunately, the majority of COVID-19 patients recover from olfactory dysfunction (OD) within the first couple of weeks. However, from approximately 5% up to 20% continue to suffer from OD even more than 1 year after the onset. Nonetheless, factors associated with long-lasting OD are hardly known. The aim of this study was to identify favourable and disadvantageous markers of persisting OD in COVID-19 patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Sixty-six patients (46 female; mean age: 39.9 years) that suffer from OD longer than 6 months due to laboratory-confirmed SARS-CoV-2 infection have participated in this longitudinal study. Participants completed comprehensive psychophysical chemosensory tests (i.e., Sniffin' Sticks = TDI) and questionnaires twice at our department—on average 219 ± 80 (T-1) and 489 ± 89 (T-2) days after the onset of symptoms, respectively. Olfactory recovery rates were associated with demographic factors and questionnaires using linear regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients below 40 years of age improved better (TDI: 4.1 ± 4.3 vs. 0.7 ± 5.8; <i>p</i> = 0.008) and achieved statistically significant higher scores (TDI: 31.5 ± 4.0 vs. 27.3 ± 6.7; <i>p</i> = 0.033) regarding psychophysical chemosensory tests. Furthermore, linear regression analysis revealed that parosmia was associated with worse orthonasal smell function (T-1: <i>β</i> = −0.346, <i>p</i> = 0.004; T-2: <i>β</i> = −0.384, <i>p</i> = 0.001), especially concerning identification subtest (T-1: <i>β</i> = −0.395, <i>p</i> = 0.001; T-2: <i>β</i> = −0.398, <i>p</i> &lt; 0.001). Moreover, increasing parosmia between T-1and T-2 led to worse orthonasal olfactory function (<i>β</i> = −0.294, <i>p</i> = 0.016).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Older age and parosmia seem to be unfavourable factors of persisting OD in COVID-19 patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"53-61"},"PeriodicalIF":1.7,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281415","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 Anaesthetic Efficacy of Tetracaine and Oxymetazoline Compared With Co-Phenylcaine in Healthy Individuals","authors":"Samuel J. M. Hale,&nbsp;Olivia Lengyel,&nbsp;Deanna Louis,&nbsp;Raymond Kim,&nbsp;Richard G. Douglas","doi":"10.1111/coa.14223","DOIUrl":"10.1111/coa.14223","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Nasal anaesthetic-decongestant sprays are commonly used prior to nasal instrumentation, such as flexible and rigid nasal endoscopy. <i>Co-phenylcaine</i> (lignocaine 5%, phenylephrine 0.5%, ENT Technologies Pty Ltd., Melbourne, VIC, Australia) is a combination spray commonly used for this purpose. However, lignocaine is less potent than other local anaesthetics, and both active constituents of <i>Co-phenylcaine</i> have a bitter taste. It was hypothesised that a combination spray containing tetracaine and oxymetazoline would both offer more potent topical anaesthesia and have a better taste.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four anaesthetic-decongestant nasal sprays were tested in 10 healthy participants (<i>Co-phenylcaine</i>, and tetracaine 0.5%, 1% and 2% with oxymetazoline 0.05%). Sensory thresholds were sequentially measured at the head of the inferior turbinate using Semmes-Weinstein monofilaments over the following hour. Participants also rated taste on a Likert-style scale, and reported whether they experienced subjective numbness of the maxillary teeth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A median peak sensory threshold of 60 g (the maximum tested) was observed with <i>Co-phenylcaine</i>, but this threshold was exceeded by all the tetracaine-based sprays. Tetracaine 2% with oxymetazoline 0.05% had a significantly more rapid onset than <i>Co-phenylcaine</i> (4 min vs. 6 min, <i>p</i> &lt; 0.05) and a longer duration of action. Eight participants reported dental numbness after administration of tetracaine 2% with oxymetazoline 0.05%, but only one participant after <i>Co-phenylcaine.</i> Tetracaine-based sprays were generally perceived to taste less unpleasant than <i>Co-phenylcaine.</i>\u0000 </p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tetracaine 2% with oxymetazoline 0.05% is a more potent and rapidly acting anaesthetic-decongestant spray than <i>Co-phenylcaine</i>, with a longer duration of action.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"46-52"},"PeriodicalIF":1.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266990","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 in Clinical Diagnosis of Head and Neck Cancer","authors":"Hollie Black,&nbsp;David Young,&nbsp;Alexander Rogers,&nbsp;Jenny Montgomery","doi":"10.1111/coa.14220","DOIUrl":"10.1111/coa.14220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Machine learning has been effective in other areas of medicine, this study aims to investigate this with regards to HNC and identify which algorithm works best to classify malignant patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>An observational cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Queen Elizabeth University Hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Patients who were referred via the USOC pathway between January 2019 and May 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Predicting the diagnosis of patients from three categories, benign, potential malignant and malignant, using demographics and symptoms data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The classic statistical method of ordinal logistic regression worked best on the data, achieving an AUC of 0.6697 and balanced accuracy of 0.641. The demographic features describing recreational drug use history and living situation were the most important variables alongside the red flag symptom of a neck lump.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Further studies should aim to collect larger samples of malignant and pre-malignant patients to improve the class imbalance and increase the performance of the machine learning models.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"31-38"},"PeriodicalIF":1.7,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266991","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":"Construction and Analysis of Risk Prediction Model of Eosinophilic Chronic Rhinosinusitis With Nasal Polyps: A Cross-Sectional Study in Northwest China","authors":"Huajie Yuan,&nbsp;Yuping Yang,&nbsp;Bo Zhang,&nbsp;Ang Li,&nbsp;Jiang Su,&nbsp;Xiaoyan Ding,&nbsp;Haisu Yan,&nbsp;Hua Zhang","doi":"10.1111/coa.14225","DOIUrl":"10.1111/coa.14225","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To provide guidance for clinical endotypes by constructing a risk-predictive model of eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Single-centre trial at tertiary medical institutions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>A cross-sectional study included 343 CRSwNP patients divided into ECRSwNP (<i>n</i> = 237) and non-ECRSwNP (<i>n</i> = 106) groups using surgical pathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Single-factor and multivariate analysis were used to identify statistically significant variables for constructing a nomogram, including the history of AR, hyposmia score, ethmoid sinus score, BEP and BEC. The model's performance was evaluated based on the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Allergic rhinitis, hyposmia score, ethmoid sinus score, peripheral blood eosinophil percentage (BEP) and eosinophil count (BEC) were retained for the construction nomogram of ECRSwNP. The nomogram exhibited a certain accuracy, with an AUC of 0.897 (95% CI: 0.864–0.930), good agreement in the calibration curve and a 0.891 C-index of internal validation. Moreover, the DCA with a threshold probability between 0.0167 and 1.00 indicated a higher net benefit and greater clinical utility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The construction of a predictive risk model of ECRSwNP based on easily accessible factors could assist clinicians in more conveniently defining endotypes to make optimal diagnoses and treatment choices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"39-45"},"PeriodicalIF":1.7,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269633","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":"Endoscopic Integrated Multipoint Laser System to Perform Quantitative Measurements for Anterior Skull Base Defects","authors":"Gani Nuredini,&nbsp;Priscilla Parmar,&nbsp;Andrew Hall,&nbsp;Annakan Navaratnam","doi":"10.1111/coa.14219","DOIUrl":"10.1111/coa.14219","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"150-154"},"PeriodicalIF":1.7,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153296","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":"Exploring the Relationships Between Clinical Examination Findings, Subjective Reported Symptoms and Objective Nasal Patency Measures in Nasal Obstruction: A Baseline NAIROS Sub-Study Analysis","authors":"Pavithran Maniam,&nbsp;Alison Bray,&nbsp;Michael Drinnan,&nbsp;Tony Fouweather,&nbsp;M. Dawn Teare,&nbsp;Sean Carrie,&nbsp;James O'Hara","doi":"10.1111/coa.14221","DOIUrl":"10.1111/coa.14221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The role of objective nasal airflow measures using peak nasal inspiratory flow (PNIF) and rhinospirometry in supporting clinical examination findings when offering patients septoplasty remain undefined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the baseline relationships between clinical examination findings, subjective reported symptoms and objective nasal patency measures in nasal obstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a sub-study of the NAIROS trial. Participants with nasal obstruction secondary to septal deviation were included in this NAIROS sub-study. The side of septal deviation, enlargement of inferior turbinate (IT), the need for IT reduction if septoplasty was being performed, the area of septum deflecting into the airway and observer rated airway block (ORAB–arbitrarily divided by &lt;50% and &gt;50% blockage) were assessed by clinicians. The subjective score of nasal obstruction was assessed using the Double Ordinal Assessed Subjective Scale (DOASS). Objective nasal patency measures (e.g., nasal partitioning ratio, [NPR] and PNIF) were measured using PNIF and rhinospirometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean NPR for left-sided, both-sided and right-sided septal deviation was −0.35, −0.02 and 0.51, respectively (<i>p</i> &lt; 0.001). There was very weak correlation between the requirement for IT reduction and PNIF change (0.13, <i>p</i> &lt; 0.01). There was no difference in mean PNIF (94 L/min vs. 93 L/min) and mean DOASS (0.33 vs. 0.38) for participants with ORAB rated &lt;50% and &gt;50%. The mean NPR for participants with ORAB &gt;50% was higher than for those with ORAB &lt;50% (0.51 vs. 0.41, <i>p</i> = 0.002). There was strong correlation between the DOASS and NPR (+0.737, <i>p</i> &lt; 0.001). The mean DOASS score for right-sided, both-sided and left-sided septal deviation was 0.32, 0.05 and −0.29, respectively (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identified strong relationships between the clinician rated side of septal deflection, the patient reported DOASS and the objective NPR measurements. NPR and the clinician rated degree of airway blockage were concordant.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"22-30"},"PeriodicalIF":1.7,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153297","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":"Efficacy and Safety of In-Office Transnasal Oesophagoscopy and Balloon Dilatation for Patients Presenting With High Dysphagia: A 6-Year Retrospective Analysis","authors":"Chang Woo Lee,&nbsp;Virginia Fancello,&nbsp;Alex Dando,&nbsp;Fenella Bennett,&nbsp;Virginia Ludwig,&nbsp;Kate J. Heathcote","doi":"10.1111/coa.14222","DOIUrl":"10.1111/coa.14222","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"143-149"},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139514","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":"Evaluation of the Management of Asymptomatic Unilateral Tonsillar Enlargement—Can We Avoid Diagnostic Surgery?","authors":"E. Tian Tan,&nbsp;Laura Simpson,&nbsp;Rory Braggins,&nbsp;Ovie Edafe","doi":"10.1111/coa.14218","DOIUrl":"10.1111/coa.14218","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"137-142"},"PeriodicalIF":1.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125048","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":"Normal Facial Function in the Sunnybrook Facial Grading System: Is the 100% Score too Restrictive?","authors":"Diane Picard,&nbsp;Remi Hervochon,&nbsp;Elodie Lannadere,&nbsp;Cloe Cabos,&nbsp;Loeiza Gourves,&nbsp;Frederic Tankere,&nbsp;Peggy Gatignol","doi":"10.1111/coa.14217","DOIUrl":"10.1111/coa.14217","url":null,"abstract":"&lt;p&gt;The Sunnybrook Facial Grading System (SFGS) is a widely recognized tool for assessing facial palsy and its subsequent recovery, offering a standardized approach for quantifying facial movements [&lt;span&gt;1&lt;/span&gt;]. This scale compares the paralyzed hemiface to the healthy hemiface of patients using a total composite score between 0% and 100%, where 100% corresponds to full recovery of facial function. The SFGS evaluate five facial movements, symmetry at rest and the presence of synkinesis. The total composite score is calculated by subtracting the symmetry and synkinesis scores from the dynamic movement score.&lt;/p&gt;&lt;p&gt;This scale and total composite score have proven to be a gold standard in clinical practice and research [&lt;span&gt;2&lt;/span&gt;]. Even if it has been shown to be more sensitive in detecting changes following therapeutic intervention, the SFGS remains largely subjective [&lt;span&gt;3&lt;/span&gt;]. Moreover, the widespread assumption of achieving a perfect 100% may not deal with the natural variations of face symmetry observed in healthy individuals and in patients with facial palsy [&lt;span&gt;4&lt;/span&gt;]. Indeed, there is valuable evidence of asymmetry in the production of facial expressions in the general population, even in the absence of facial palsy [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;This study aims to provide a more comprehensive understanding of the natural range of SFGS scores among healthy participants, thereby redefining the normative standards and advocating for a more patient-centred and holistic approach to facial rehabilitation.&lt;/p&gt;&lt;p&gt;Upon analyzing the SFGS scores, it was observed that the range differed depending on whether the right or left hemiface was considered the reference. Taking the right hemiface as a reference, SFGS-Total scores ranged from 65% to 100% (median = 96, IQR [91–100]). When the left hemiface was considered as the reference, scores ranged from 78% to 100% (median = 95; IQR [90–100]). No participants showed any synkinesis. No significant differences between the SFGS-Total scores according to the reference hemiface were found on the whole sample (&lt;i&gt;p&lt;/i&gt; = 0.517). The data are reported by age and gender in Table 1. Data distribution using violin plots is reported in Figure 1.&lt;/p&gt;&lt;p&gt;Consistency between evaluators were high for right and left SFGS-Total scores (respectively α = 0.953 and α = 0.926). Right and left SFGS-Rest scores showed also high inter-rater reliability (respectively α = 0.860 and α = 0.886) as well as right and left SFGS-Movement scores (respectively α = 0.957 and α = 0.816).&lt;/p&gt;&lt;p&gt;There was a slight negative correlation between age and SFGS-Total scores. Indeed, the older the participants, the lower their scores (right side as reference: ρ (109) = −0.37, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001, 95% CI [−0.52, −0.20]; left side as reference: ρ (109) = −0.25; &lt;i&gt;p&lt;/i&gt; = 0.009; 95% CI [−0.42, −0.06], Figure 2). Post hoc comparisons using Kruskall–Wallis test indicated that there was a significant difference in the SFGS-Total scores (right","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"132-136"},"PeriodicalIF":1.7,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104972","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}