Clinical Otolaryngology最新文献

{"title":"Causal Effects of Gastroesophageal Reflux on Chronic Rhinosinusitis: A Bidirectional Two-Sample Mendelian Randomization Study","authors":"Xiang Xin,&nbsp;Yang Yang,&nbsp;Li Xuelei,&nbsp;Yao Hongbing,&nbsp;Tang Xinye,&nbsp;Liang Jia","doi":"10.1111/coa.14251","DOIUrl":"10.1111/coa.14251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Observational studies have shown a bidirectional association between gastroesophageal reflux (GER) and chronic rhinosinusitis (CRS) or chronic rhinitis (CR), but it is not clear whether this association is causal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study was to investigate the causality between GER and CRS or CR using bidirectional two-sample Mendelian randomization (MR) analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using pooled data from large genome-wide association studies (GWAS), genetic loci independently associated with GER, CRS and CR in populations of European and American ancestry were selected as instrumental variables (IVs). The inverse variance weighted (IVW) method was used to analyse the random effects model of MR, and the odds ratio (OR) was used as the evaluation index to explore the bidirectional causality between GER and CRS or CR. Single nucleotide polymorphism (SNP) outliers were detected using MR-pleiotropy Residual Sum and Outliers (MR-PRESSO). The MR–Egger intercept test examined the horizontal pleiotropy of SNPs. The “leave-one-out” sensitivity analysis examined whether MR results were affected by a single SNP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The main results of IVW showed that GER increased the risk of CRS (OR = 1.3795, 95% CI = 1.188–1.603, <i>p</i> &lt; 0.0500) and CR (OR = 1.3941, 95% CI = 1.1671–1.6652, <i>p</i> &lt; 0.0500). The obtained SNPs as IVs for GER, CRS and CR had no significant horizontal pleiotropy, heterogeneity or bias. Regarding the reverse directions, no notable associations could be found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This MR analysis revealed that genetically predicted GER had a causal effect on an increased risk of CRS or CR, but not vice versa. These results have great implications for the management of CRS (especially for refractory CRS) or CR in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"280-287"},"PeriodicalIF":1.7,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567279","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":"Safety of Simultaneous Surgery for Pituitary Neoplasms and Rhinosinusitis","authors":"Hye-Bin Jang,&nbsp;Dong Hoon Lee,&nbsp;Shin Jung,&nbsp;Sang Chul Lim","doi":"10.1111/coa.14248","DOIUrl":"10.1111/coa.14248","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"375-380"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557318","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":"Psychological Challenges in Children With Tracheostomies and Their Families—A Qualitative Study","authors":"Mairi Weir,&nbsp;Haytham Kubba","doi":"10.1111/coa.14249","DOIUrl":"10.1111/coa.14249","url":null,"abstract":"&lt;p&gt;Approximately 1,200 children require a new tracheostomy every year in the United Kingdom [&lt;span&gt;1&lt;/span&gt;], and most are in place for more than 2 years, requiring prolonged periods of care at home [&lt;span&gt;2&lt;/span&gt;]. The stress and worry associated with tracheostomy care can affect the whole family. Parents often feel an altered sense of their parental role and many suffer poor mental health [&lt;span&gt;3-5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;As far as we are aware, no paediatric airway service in the UK has a dedicated clinical psychologist who sees all families in the service. In our catchment area, psychological support for children and families is available on referral to the Paediatric Clinical Psychology Service (PCPS) but this is done on a case-by-case basis and is not routinely integrated into the airway team. This qualitative study aims to explore parents' thoughts on the psychological support we currently offer at our tertiary paediatric centre by generating and exploring ideas through in-depth discussions with a small number of test subjects.&lt;/p&gt;&lt;p&gt;Parents of children with tracheostomy are well-trained in clinical aspects of care and most rapidly become experts in their child's condition [&lt;span&gt;6&lt;/span&gt;]. Some parents consider their child's quality of life to be higher than their own [&lt;span&gt;7&lt;/span&gt;] and lower perceived quality of life may have a negative impact on a parent's caregiving abilities. Some parents struggle to participate in their child's tracheostomy care due to feeling overwhelmed [&lt;span&gt;8&lt;/span&gt;]. Psychological support can be invaluable in improving the long-term outcomes for both patient and their family. Previous studies have suggested that having a member of staff on hand who is familiar with the family can be invaluable [&lt;span&gt;9&lt;/span&gt;]. Psychological support needs change over time, with parents wanting help in the early stages, while children may benefit most when they are older, especially during important times of transition such as starting school [&lt;span&gt;10&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The main value of qualitative research is in identifying areas that are important to patients but which might be surprising to clinicians. Our biggest surprise was the lack of any perceived stigma in accessing psychological services. We expected this to be a major barrier to families accessing care but we were pleasantly surprised to see no sign of reticence on the part of parents in seeking psychological support. On the contrary, 70% actively requested referrals.&lt;/p&gt;&lt;p&gt;Our study is small, but that is often the way with qualitative studies, where in-depth analysis of response themes is more important than large study numbers. Our sample is representative of our tracheostomy cohort overall and the responses were consistent from family to family. The qualitative element of the study allowed us insights into parents' priorities, particularly the importance of long-term continuity in care. The main outcome is the strong demand from parents for integrated psychological suppor","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"370-374"},"PeriodicalIF":1.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496359","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":"Current Practice, Safety and Efficacy of Interventions for Recurrent Respiratory Papillomatosis: Evidence From a UK Registry","authors":"Adam J. Donne,&nbsp;Kim Keltie,&nbsp;Julie Burn,&nbsp;Emma Belilios,&nbsp;Steven Powell,&nbsp;Paola Cognigni,&nbsp;Iain J. Nixon,&nbsp;Neil Bateman,&nbsp;Haytham Kubba,&nbsp;Owen Judd,&nbsp;Andrew Sims","doi":"10.1111/coa.14245","DOIUrl":"10.1111/coa.14245","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the current practice, safety and efficacy of interventions used in the management of recurrent respiratory papillomatosis (RRP) in the UK NHS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective registry (recruitment between 1st April 2018 and 31st August 2022, retrospective data from 1st January 2015 permitted with consent). Sub-group data-linked to Hospital Episode Statistics for additional follow-up (until 31st July 2022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>UK NHS hospitals treating RRP patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Children and adults diagnosed with RRP and managed in an NHS hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Disease severity (Derkay, voice handicap and GRBAS scores), management (type and frequency of surgical and adjuvant intervention) and complications (cancer, death).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three hundred and thirty patients were entered into the registry; 304 (including 65 children) were eligible for analysis. Children had more severe disease than adults (median Derkay score 10 vs. 5). Microdebrider was the most common surgical intervention, particularly in children (86% of children, 49% of adults). Additionally, lasers (CO₂, KTP and pulsed dye) were used in 34% of adults. Gardasil was the most common adjuvant therapy (21 children, 23 adults). Procedural complications were rare (10.8% children, 5.9% adults). Five patients developed laryngeal malignancy; there were six deaths during follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the largest UK RRP study to date. RRP is more aggressive in children than adults, and treatment choice differs between age groups. Overall, management was safe with minimal complications reported, and generally effective in maintaining a safe airway. Standardised reporting is required to objectively monitor disease progression and safety over time.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> NCT03465280, ISRCTN36100560</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"271-279"},"PeriodicalIF":1.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496356","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":"Differential Nasal Recolonization and Microbial Profiles in Chronic Rhinosinusitis With Nasal Polyps Patients After Endoscopic Sinus Surgery or Dupilumab Treatment: A Prospective Observational Study","authors":"Antonino Maniaci,&nbsp;Gaia Vertillo Aluisio,&nbsp;Stefania Stefani,&nbsp;Salvatore Cocuzza,&nbsp;Jerome Rene Lechien,&nbsp;Thomas Radulesco,&nbsp;Justin Michel,&nbsp;Maria Santagati,&nbsp;Ignazio La Mantia","doi":"10.1111/coa.14246","DOIUrl":"10.1111/coa.14246","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The role of microbial profiles in Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) pathogenesis is increasingly recognised, with microbial imbalances perpetuating inflammation. We performed this study to associate the different nasal microbiological profile changes with the response to surgical or monoclonal treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective observational study evaluated changes in the nasal microbial profiles of 44 patients (22 dupilumab, 22 surgery) over 6 months. Clinical assessments were performed at baseline and follow-ups, including Sino-Nasal Outcome Test-22 (SNOT-22) scores and Sniffin Sticks-Identification (SS-I) olfactory testing. Microbial profiling of nasal swabs was carried out by microbial culture and subsequent molecular identification by Polymerase chain reaction (PCR) and sequencing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline characteristics of 44 patients (22 dupilumab, 22 surgery) enrolled in this study were similar between groups. In the dupilumab group, <i>Staphylococcus epidermidis</i> prevalence rose from 37.03% to 59.25%, while <i>Pseudomonas aeruginosa</i> was eradicated. Moreover, dupilumab stabilised <i>Staphylococcus aureus</i> at 63.64%, while its prevalence increased in the surgery group (from 22.72% to 50%). When bacterial groups were associated with clinical scores, <i>P. aeruginosa</i> carriers had worse SNOT-22 (21.00 ± 1.41) and SS-I (5.50 ± 0.71) scores. Instead, <i>S. epidermidis</i>-colonised patients exhibited significantly lower mean SNOT-22 (15.39 ± 8.54) and greater SS-I scores (8.39 ± 3.77). The best outcomes were found in the subgroup of <i>S. epidermidis</i> carriers undergoing the dupilumab treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The two treatments modulated the microbial profiles differently, and, most importantly, clinical responses might depend on the association between treatment and the dominant bacterial species colonising the nasal cavity. Further investigation into microbial-restorative strategies could enhance outcomes for better treatment of CRS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"262-270"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496357","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":"Otosyphilis—A Type of Refractory Deafness","authors":"Jingman Deng,&nbsp;Yan Huang,&nbsp;Wuhui He,&nbsp;Jintao Lou,&nbsp;Wei Liu,&nbsp;Zhigang Zhang,&nbsp;Yu Si","doi":"10.1111/coa.14224","DOIUrl":"10.1111/coa.14224","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"358-364"},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496358","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 Cold-Steel Dissection Tonsillectomy Protocol That Consistently Produces Few Complications in Paediatric Tonsillectomy: A Review of 953 Patients","authors":"Yohanna M. Takwoingi,&nbsp;Shiraz Syed,&nbsp;Oghogho Braimah","doi":"10.1111/coa.14250","DOIUrl":"10.1111/coa.14250","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"365-369"},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459656","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":"Expression of AQP8 in Serum of Patients With Meniere's Disease and Its Value in Evaluating the Degree of Hydrolabyrinth and Predicting Prognosis","authors":"Rui Zhao,&nbsp;Tianhua Yi,&nbsp;Qinqin Wu,&nbsp;Xuemei Liu,&nbsp;Jianqiao He,&nbsp;Yufang Tan","doi":"10.1111/coa.14241","DOIUrl":"10.1111/coa.14241","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to explore the role of serum aquaporin 8 (AQP8) expression in evaluating the degree of hydrolabyrinth and predicting prognosis in patients with Meniere's disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred and five patients diagnosed with Meniere's disease in our hospital were enrolled in the Meniere's disease group. Another 102 healthy subjects were enrolled as the control group. The expression of serum AQP8 mRNA was determined by the quantitative real-time PCR (qRT-PCR) method. Receiver operating characteristic (ROC) curve analysis was carried out to analyse the predictive value of serum AQP8 mRNA expression for poor prognosis in Meniere's disease patients. Multivariate logistic regression was used to analyse the influencing factors of poor prognosis in patients with Meniere's disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The expression level of serum AQP8 mRNA in the Meniere's disease group was significantly higher than that in the control group (<i>p</i> &lt; 0.05). In the severe hydrops group, serum AQP8 mRNA expression levels were higher than in the mild hydrops group and the no endolymphatic hydrops group. Additionally, the mild hydrops group had higher serum AQP8 mRNA levels than the no endolymphatic hydrops group (<i>p</i> &lt; 0.05). The disease course, proportion of severe hydrops and serum AQP8 mRNA expression were all higher in the poor prognosis group compared to the good prognosis group (<i>p</i> &lt; 0.05). The area under the curve (AUC) for serum AQP8 mRNA in predicting poor prognosis in Meniere's disease patients was 0.812 (95%<i>CI</i>: 0.702–0.922).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AQP8 mRNA is associated with the degree of hydrolabyrinth in patients with Meniere's disease and plays an important role in predicting prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"255-261"},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459668","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":"Impairment of Internal Auditory Canal Barrier in Meniere's Disease","authors":"Weidong Zhang,&nbsp;Jiapei Xie,&nbsp;Songbai Li,&nbsp;Bo Zhang","doi":"10.1111/coa.14242","DOIUrl":"10.1111/coa.14242","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this investigation was to explore the potential correlation between the signal intensity ratio (SIR) at the internal auditory canal (IAC) fundus and hearing impairment in Meniere's disease (MD), thereby providing a foundation to further understand the mechanisms underlying hearing loss.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Fifty patients diagnosed with unilateral definite MD were enrolled in the study. 3D-FLAIR MRI was conducted 4 h after intravenous administration of gadobutrol to determine the SIR of the bilateral IAC fundus. The difference in the SIR of the IAC fundus between the affected and unaffected sides was assessed, followed by an analysis of its correlation with low-, middle-, and high-tone hearing thresholds. Correlation analysis was also conducted between the degree of endolymphatic hydrops (EH) in the vestibule and cochlea and the SIR on the affected side.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The degree of EH in MD can be clearly visualised using 3D-FLAIR MRI. The SIR on the affected side was significantly higher than that on the unaffected side (<i>p</i> = 0.000). Furthermore, a positive correlation was observed between the SIR at the affected and low (<i>r</i> = 0.692, <i>p</i> = 0.000), middle (<i>r</i> = 0.615, <i>p</i> = 0.000) and high-tone (<i>r</i> = 0.440, <i>p</i> = 0.001) hearing thresholds, while the SIR showed no significant correlation with cochlear (<i>r</i> = 0.315, <i>p</i> = 0.088) or vestibular hydrops (<i>r</i> = 0.215, <i>p</i> = 0.244).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The IAC fundus barrier may be damaged in patients with MD, representing one of the factors affecting the level of hearing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"249-254"},"PeriodicalIF":1.7,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459669","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":"Results of Platelet-Rich Fibrin Application in Pharyngeal Reconstruction After a Total Laryngectomy","authors":"Ayça Başkadem Yilmazer,&nbsp;Elif Aksungur,&nbsp;Cem Çelik,&nbsp;Avni Akin Bayram,&nbsp;Hüseyin Turgut,&nbsp;Mehmet Emre Dinç,&nbsp;Ayşe Enise Göker,&nbsp;Yavuz Uyar","doi":"10.1111/coa.14247","DOIUrl":"10.1111/coa.14247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pharyngocutaneous fistula (PCF) is one of the most challenging complications observed after a total laryngectomy. Since the biochemical components of platelet-rich fibrin (PRF) have well-known synergistic effects on the healing processes, this study aimed to demonstrate the contribution of PRF application to pharyngeal healing in patients undergoing a total laryngectomy for laryngeal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study compared patients who underwent a total laryngectomy due to laryngeal squamous cell carcinoma and had a PRF membrane placed during the pharyngoesophageal closure with those who did not. There were two groups: PRF-positive and PRF-negative. In the PRF-positive group, after the completion of the total laryngectomy and moving on to the pharyngoesophageal closure stage, along the suture line, PRF material is laid in two pieces in a T-shape and secured with several sutures. No PRF application was done in the PRF-negative group. Pharyngeal healing steps (nasogastric feeding, oral feeding, development of a fistula), haemoglobin and albumin values, tumour involvement areas, time to oral intake and length of hospital stay were recorded for all patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study reviewed the records of 33 patients who underwent pharyngoesophageal closure with PRF application after a total laryngectomy (PRF-positive group) and 35 patients without PRF application (PRF-negative group). When comparing patients in terms of developing a PCF, 6% (<i>n</i> = 2) of patients in the PRF-positive group and 25.7% (<i>n</i> = 9) in the PRF-negative group developed a fistula. This ratio was significantly higher in the PRF-negative group (<i>p</i> = 0.027).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The application of PRF in pharyngoesophageal reconstruction after a total laryngectomy may strengthen wound healing and reduce the risk of PCF development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>This study is a retrospective designed study; therefore, there is no clinical trial registration</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"122-127"},"PeriodicalIF":1.7,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459671","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}