European Archives of Oto-Rhino-Laryngology最新文献

{"title":"Office-based flexible endoscopic guided biopsy: single-center feasibility analysis.","authors":"Nisha, Vimmi Gautam, Smriti Panda, Alok Thakar, Akshara Palreddy, Rajeev Kumar, Chirom Amit Singh, Kapil Sikka","doi":"10.1007/s00405-024-09076-z","DOIUrl":"https://doi.org/10.1007/s00405-024-09076-z","url":null,"abstract":"<p><strong>Background: </strong>Direct laryngoscopy and biopsy have been the standard of care for biopsy of lesions arising from the upper aerodigestive tract (UADT). The requirement of general anesthesia is often a prerequisite. Procedures performed under the laryngeal block and local anesthesia are not viewed as appropriate from the point of view of patient comfort. Office-based flexible guided biopsy offers a less invasive alternative for obtaining biopsies from UADT.</p><p><strong>Objective: </strong>To evaluate the yield, accuracy, feasibility, and safety of office-based flexible fiber-optic endoscope-directed biopsy (FEB) for laryngeal & pharyngeal lesions.</p><p><strong>Methods: </strong>Setting- Tertiary care referral center.Retrospective cohort of FEB procedures undertaken in the period from June-December 2022.</p><p><strong>Results: </strong>The study sample included 181 consecutive patients (median age 59 years) with lesions in supraglottis-25.4%, glottis-20.4%, nasopharynx-6%, oropharynx (base tongue/vallecula)-24.8%, and hypopharynx(pyriform fossa)-23.2%. The median time from outpatient visit to FEB was 1.9 days (1-4 days). Malignancy was confirmed in 166/181 patients, with 8 pre-malignant and 7 benign lesions. FEB confirmed the appropriate diagnosis in 159/181 (88.1%), and a repeat FEB in the 22 non-diagnostic situations yielded a diagnosis in another 8 (92.8% overall). The remaining 14 patients were appropriately diagnosed by a subsequent operating room endoscopy. The rate of conversion to direct laryngoscopy biopsy was approximately 7.73%. FEB demonstrated sensitivity (86.8%), specificity (100%), Positive Predictive Value (100%), Negative Predictive Value (23.3%), and overall Accuracy (87.29%). Univariate analysis indicated poor diagnostic yield for nasopharynx subsite (OR - 0.15; p = 0.003) and post-radiation/chemoradiation cases(OR - 7.04; p = 0.05). Multivariate analysis of the impact of patient characteristics, lesion subsite/morphology, and prior tracheostomy did not reveal a statistically significant association with histological yield. Mean biopsy time was 8 min with minor complications (pain/ minor bleeding) in 29/203 FEB procedures (14.28%), and major complications in 12(5.9%) (significant bleeding-2, airway compromise-9; death-1).</p><p><strong>Conclusion: </strong>Office-based FFB is a viable alternative to direct laryngoscopic guided biopsy with acceptable sensitivity and specificity. Appropriate utilization of FFB will reduce the need for direct laryngoscopy.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of electrode array design, scalar dislocation and insertion technique on postoperative vertigo in CI surgery - a prospective study.","authors":"Manuel Christoph Ketterer, A K Rauch, R L Beck, T F Jakob, L Fries, A Aschendorff, S Arndt, F Everad","doi":"10.1007/s00405-024-09147-1","DOIUrl":"https://doi.org/10.1007/s00405-024-09147-1","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the effect of electrode array design, insertion angle, scalar position, and insertion technique on the occurrence of postoperative subjective vertigo following cochlear implant (CI) surgery using questionnaires in conjunction with objective vestibular functional measurements.</p><p><strong>Materials and methods: </strong>We prospectively evaluated subjective vertigo using the Dizziness Handicap Inventory (DHI). Additionally, we performed videonystagmography, video head-impulse tests, and vestibular-evoked myogenic potentials to assess the objective vestibular function preoperatively, at four weeks and 12 months after CI. These results were compared with those of postoperative imaging using digital volume tomography.</p><p><strong>Results: </strong>Postoperative vertigo was observed in 2 out of 62 patients (3%). Cochleostomy (n = 8) did not lead to an increase in postoperative vertigo. Functional diagnostics revealed abnormalities in up to 23% of patients without subjective dizziness. In our patient cohort, neither electrode array dislocation nor increasing insertion depth was associated with an increase in postoperative vertigo.</p><p><strong>Conclusion: </strong>Both postoperative vertigo occurrence and electrode array dislocation rates have significantly decreased due to the optimized atraumatic electrode array design and improved surgical insertion techniques. Neither dislocation nor cochleostomy appeared to induce vertigo but the sample size was too small to draw definitive conclusions.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic septal perforation repair by endonasal flap: a technique using mobilized septal bone or cartilage for support.","authors":"Goran Latif Omer, Stefano Di Girolamo, Sahand Soran Ali, Rekawt Hama Rashid Kareem, Aland Salih Abdullah, Riccardo Maurizi, Gianluca Velletrani, Beatrice Francavilla, Othman Hussein, Kosar Hama Noori, Aso Khasraw Ahmed, Amanj Hamaamin Hamaamin","doi":"10.1007/s00405-024-09136-4","DOIUrl":"https://doi.org/10.1007/s00405-024-09136-4","url":null,"abstract":"<p><strong>Purpose: </strong>Septal perforation refers to a defect within the nasal septum, which subsequently creates communication between the two nasal cavities. More than one surgical approach has been described to repair nasal septal perforations; however, they have a high rate of complication. We aim to introduce a new technique of endoscopic repair of septal perforations, which supports the flap and is thus used to prevent commonly encountered complications.</p><p><strong>Methods: </strong>This is a prospective cohort study with 40 patients who underwent thorough clinical examination, including nasal endoscopy, to determine the perforation details. This was followed by computed tomography (CT) scans and blood tests, which were done to exclude granulomatous disease, tumours, base of skull defects, polyps, etc. This new technique uses either a piece of cartilage alone or cartilage combined with a bone to support the flap. In the assessment, the perforation sizes were categorized, and a treatment plan was made for each.</p><p><strong>Results: </strong>The patients in the study were evaluated, and their most common complaint was crusting. Most patients with less than 1 cm perforations did not need support; the majority of those with 1-2 cm perforations required cartilage support, and 2-3 cm perforations required cartilage and bone support.</p><p><strong>Conclusion: </strong>We have proposed a new endoscopic technique that involves using cartilage and bone grafts to support the flaps used for nasal septal perforation repair and reduce the risk of associated complications.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing evidence-based surgical strategies for pulsatile tinnitus. Comment on the author's reply.","authors":"Aynur Aliyeva","doi":"10.1007/s00405-024-09132-8","DOIUrl":"https://doi.org/10.1007/s00405-024-09132-8","url":null,"abstract":"","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of listening effort, real-life outcome, auditory working memory and attention in school-going children with cochlear implant.","authors":"Thejaswini Mirle Ramesh, Kamath Disha Deepak, Chinnaraj Geetha","doi":"10.1007/s00405-024-09135-5","DOIUrl":"https://doi.org/10.1007/s00405-024-09135-5","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the listening effort using objective test (dual-task paradigm), parents report using abbreviated version of the Speech, Spatial and Quality questionnaire (SSQ-P10) and Teachers' Evaluation of Aural/Oral Performance of Children and Ease of Listening (TEACH), working memory and attention span between children using cochlear implants (CI) and age-matched peers with normal hearing sensitivity, and assess the relationship between listening effort and real-life benefit in children using CI.</p><p><strong>Method: </strong>Group I included 25 children with normal hearing sensitivity. Group II included 25 children with bimodal cochlear implantation with bilateral severe to profound hearing loss. The listening effort was assessed using the dual-task paradigm and SSQ-P10 whereas the TEACH questionnaire was used to assess the real-life outcome in children with CI. Also, digit span forward, digit span backward, and sound count test from CLAP-C were performed to assess working memory and attention, respectively.</p><p><strong>Results: </strong>The results revealed that children with normal hearing sensitivity performed significantly better in dual-task paradigm, real-life outcome measures, digit span forward test, digit span backward test and attention test of sound count than children with CI. There was a correlation between reaction time in dual-task paradigm and real-life outcome measures.</p><p><strong>Conclusion: </strong>Listening effort and cognitive abilities are affected in children with CI. Listening effort can be measured in school-going children with cochlear implantation. Training may be required to improve real-life activities and improve the cognitive abilities of children with CI.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Novel technique utilizing polymethylmethacrylate cement for the treatment of Pulsatile Tinnitus caused by different sigmoid sinus pathologies.","authors":"Aynur Aliyeva","doi":"10.1007/s00405-024-09123-9","DOIUrl":"https://doi.org/10.1007/s00405-024-09123-9","url":null,"abstract":"","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT scoring system for differentiating of sinonasal inverted papilloma and squamous cell carcinoma arising from inverted papilloma.","authors":"Miki Umeda, Masashi Kuroki, Hiroki Kato, Hirofumi Shibata, Nansei Yamada, Hiroshi Okuda, Kosuke Terazawa, Ryota Iinuma, Akira Ohkoshi, Shun Wakamori, Ikuho Kojima, Yukio Katori, Masayuki Matsuo, Takenori Ogawa","doi":"10.1007/s00405-024-09107-9","DOIUrl":"https://doi.org/10.1007/s00405-024-09107-9","url":null,"abstract":"<p><strong>Objective: </strong>To distinguish squamous cell carcinoma in inverted papilloma (IP-SCC) from IP, the utility of CT scoring system was investigated.</p><p><strong>Methods: </strong>We extracted cases histopathologically diagnosed with IP and IP-SCC of the sinonasal cavity from June 2004 to May 2021. Preoperative unenhanced CT images were used to evaluate the presence or absence of bone destruction and erosion: Score 1 = positive for bone destruction and/or erosion; Score 0 = negative for bone destruction and erosion. The CT scores in 10 sites of the sinonasal cavity and their adjacent areas were calculated.</p><p><strong>Results: </strong>Fifty-six cases of IP and 20 cases of IP-SCC were enrolled in this study. Bone destruction and/or erosion was more frequently observed in IP-SCC than in IP at the sites of the skull base (p = 0.0001), orbital wall (p < 0.0001), maxillary sinus (p < 0.0001), nasal septum (p < 0.0001), inferior nasal concha (p = 0.0046), ethmoid sinus (p < 0.0001), pterygoid process (p = 0.0031), and frontal sinus (p = 0.0009). The total CT scores at the 10 sites for diagnosing IP-SCC had sensitivity and specificity of 70% and 87.5% (AUC: 0.810, p < 0.001); furthermore, those at the eight sites excluding fontanelle and middle nasal concha improved sensitivity and specificity of 75% and 83.9% (optimal threshold of 2, AUC: 0.862, p < 0.001).</p><p><strong>Conclusion: </strong>The CT scoring system evaluating bone destruction and erosion could accurately differentiate IP-SCC from IP.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empty nose syndrome: new insights from a CFD approach.","authors":"Francisco Esteban-Ortega, Lina Rosique-López, Jaime A Ochoa-Ríos, Rafael Rodríguez-Romero, Manuel A Burgos-Olmos","doi":"10.1007/s00405-024-09122-w","DOIUrl":"https://doi.org/10.1007/s00405-024-09122-w","url":null,"abstract":"<p><strong>Objectives: </strong>Empty Nose Syndrome (ENS) is a debilitating condition which usually arises after aggressive turbinate reduction. However, objective tests to help in the diagnosis of this condition are lacking. Accurate diagnosis of ENS patients is critical for effective diagnosis and treatment. The article's objectives are to utilize computational fluid dynamics (CFD) to analyze nasal airflow resistance and symmetry in suspected ENS patients, classify them into distinct groups based on CFD data, and demonstrate the potential of CFD analysis in refining ENS diagnosis and guiding individualized treatment strategies.</p><p><strong>Methods: </strong>This study involved 48 patients diagnosed of ENS. However, we only considered those patients with documented prior turbinate surgery (eventually plus septal surgery), CT scan with signs of prior surgery, and a history of ENS with symptoms included in the ENS Q6. We employed computational fluid dynamics (CFD) to analyze nasal airflow resistance and symmetry. Patients were classified into three groups based on their CFD data: low resistance and normal symmetry, evident asymmetry, and normal CFD parameters.</p><p><strong>Results: </strong>Half of patients (24 out of 48) were found in the low resistance and normal symmetry group, indicating 'typical' ENS. A smaller group (8) exhibited evident asymmetry, suggesting unilateral ENS or failure of previous surgery. Finally, 16 patients whose CFD parameters are inside the normal range of flow and resistance were classified in the normal breathing group.</p><p><strong>Conclusions: </strong>Our findings highlight the value of CFD analysis in classifying ENS patients based on airflow characteristics, as CFD analysis seems helpful in refining the diagnosis of ENS. This classification system can potentially aid in tailoring individual treatment strategies and improving patient outcomes. Further research is necessary to validate these results and explore the clinical implications of different ENS subgroups.</p><p><strong>Level of evidence: </strong>Level 4 [1].</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing implants in pediatrics with cochlear nerve deficiency: an updated systematic review.","authors":"Asma Alahmadi, Yassin Abdelsamad, Nouf A AlAmari, Mohammed Y Alyousef, Murad Al-Momani, Fahad N Altamimi, Salman F Alhabib, Abdulrahman Hagr","doi":"10.1007/s00405-024-09087-w","DOIUrl":"https://doi.org/10.1007/s00405-024-09087-w","url":null,"abstract":"<p><strong>Objective: </strong>Cochlear nerve deficiency (CND) accounts for about one-third of congenital hearing loss cases and presents several challenges during management. Currently, cochlear implant (CI) and auditory brainstem implants (ABI) represent the primary management options for CND. However, robust evidence on the outcomes of different CND management approaches remains limited. Therefore, this systematic review seeks to update and assess the effectiveness of various CND management approaches.</p><p><strong>Databases reviewed: </strong>PubMed, Scopus, Web of Science, and CENTRAL databases.</p><p><strong>Methods: </strong>We conducted an online bibliographic search across these databases. We included both interventional and observational studies evaluating CND management outcomes.</p><p><strong>Results: </strong>Of the 25 studies included, there were retrospective chart reviews, prospective observational studies, and one phase I clinical trial. Most studies focused on children with cochlear nerve aplasia or hypoplasia, with one study including patients with CHARGE syndrome. The mean age at the time of operation ranged from 0.5 to 4.5 years. Tools like the categories of auditory performance (CAP), speech intelligibility rating (SIR), and speech perception category (SPC) were commonly employed. CI outcomes were reported in 17 studies, while ABI outcomes were reported in 4 studies. The study found that the outcomes of both interventions were variable across the included studies.</p><p><strong>Conclusion: </strong>While CI is feasible and an option in children with CND, its overall effectiveness is limited in some cases like cochlear nerve aplasia. Conversely, ABI appears to be a promising alternative with better auditory, speech, and learning outcomes.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cortical bone total ossicular graft supported with crescent-shaped cartilage.","authors":"Ibrahim Erdim, Ismail Hologlu, Alara Izgic","doi":"10.1007/s00405-024-09131-9","DOIUrl":"https://doi.org/10.1007/s00405-024-09131-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the hearing outcomes of patients who underwent different type 4 tympanoplasty techniques.</p><p><strong>Methods: </strong>Patients who underwent tympanoplasty for chronic otitis media and were treated with cortical bone total ossicular prosthesis supported with crescent-shaped cartilage (Group 1), cortical bone total ossicular prosthesis (Group 2) and titanium total ossicular prosthesis (Group 3) were included in the study. Hearing outcomes were evaluated and compared with audiological tests performed before and at least 1 year after surgery.</p><p><strong>Results: </strong>There were 12 patients in Group 1 (6 males and 6 females), 14 patients in Group 2 (6 males and 8 females) and 18 patients in Group 3 (10 males and 8 females). After reconstruction, the air conduction threshold changed from 56.83 ± 13.63 to 32.25 ± 13.55 dB in Group 1, from 57.43 ± 15.3 to 40.07 ± 18.8 dB in Group 2 and from 55.39 ± 15.59 to 42.22 ± 17.32 dB in Group 3. Air-bone gap (ABG) changed from 37.58 ± 9.56 to 15.08 ± 9.58 dB in Group 1, from 36.71 ± 10.84 to 21.07 ± 11.16 dB in Group 2 and from 34.5 ± 11.72 to 22.28 ± 10.13 dB in Group 3. Preoperative and postoperative outcomes of all three groups in terms of both air conduction threshold and air-bone gap were significantly different (p < 0.01). Preoperative and postoperative changes in air conduction threshold of the three groups were also significantly different (p = 0.037). However, the differences among the three groups in terms of preoperative and postoperative changes in ABG were not significant (p = 0.057).</p><p><strong>Conclusions: </strong>Cortical bone supported with crescent-shaped cartilage total ossicular prosthesis had better hearing outcomes than other groups.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}