European Archives of Oto-Rhino-Laryngology最新文献

{"title":"The effect of single-layer and double-layer graft usage in tympanoplasty on hearing and graft success.","authors":"Zülal Kara, Selahattin Genç, Halil Erdem Özel, Fatih Özdoğan, Sebla Çalışkan","doi":"10.1007/s00405-024-09117-7","DOIUrl":"https://doi.org/10.1007/s00405-024-09117-7","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, we investigated whether the use of double layer graft (DLG) in tympanoplasty would increase grafting success rates (GSR) and whether increased graft thickness would negatively affect hearing.</p><p><strong>Methods: </strong>The study group consisted of patients with DLG and the control group consisted of patients with single layer graft (SLG). The results of 195 patients in terms of hearing achievement and 211 patients in terms of GSR were compared.</p><p><strong>Results: </strong>Hearing and GSR were analyzed in 103 DLG and 108 SLG patients. Postoperative 6th month air conduction pure tone averages were 25.34 (±14.99) dB in DLG group and 20.50 (±8.82) dB in SLG group. These values were statistically significantly higher in the DLG group (p=0.005). Postoperative air bone gap was 11.40 (±8.61) dB in DLG and 12.95 (±10.88) dB in SLG and there was no statistically significant difference in hearing gain between the groups. GSR was 99/103 (96.1%) in the DLG group and 103/108 (95.4%) in the SLG group with no difference between the groups (p=0.679) CONCLUSION: We concluded that DLG is not superior to SLG in terms of both hearing and GSR, and may even be disadvantageous in terms of hearing, and this should be taken into consideration in patient selection.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791322","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 properties of laryngeal electromyography in the non-paralyzed sides of patients with idiopathic vocal cord paralysis.","authors":"Xiao-Hong Liu, Jing-Yan, Na-Li, Qing-Qing Zhang, Meng-Xie, Nan-Cao, Min-Juan Yang, Hua-Nan Luo","doi":"10.1007/s00405-024-09116-8","DOIUrl":"https://doi.org/10.1007/s00405-024-09116-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the injuries of the recurrent laryngeal nerve (RLN), superior laryngeal nerve (SLN), and their innervated laryngeal muscles on the non-paralyzed sides in patients with idiopathic vocal cord paralysis (IVCP).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eighty-four cases of patients with IVCP were evaluated using stroboscopic laryngoscopy, voice analysis, and laryngeal electromyography(LEMG). Concurrently, twenty-eight cases involving healthy volunteers without vocal cord paralysis were enrolled and examined using LEMG during the same period. Subsequently, comparisons of LEMG results were conducted between the paralyzed and non-paralyzed sides, and among the non-paralyzed sides.Furthermore, a comparison was conducted between the LEMG results of the non-paralyzed sides in patients with IVCP and the corresponding ipsilateral sides in healthy volunteers.These comparisons were stratified based on the side of paralysis and the duration of the disease course (less than 3 months versus more than 3 months) for IVCP patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Initially, the amplitude of the RLN, the action potential durations (APDs) and amplitude of the thyroarytenoid muscle (TM), and the amplitude of the posterior cricoarytenoid muscle (PCM) on the paralyzed side were significantly lower than those on the non-paralyzed side. Conversely, the latency of the RLN on the paralyzed side was significantly longer compared to the non-paralyzed side (P &lt; 0.05). However, there were no significant differences in the latency and amplitude of the SLN, nor in the APD and amplitude of the CM between the paralyzed and non-paralyzed sides (P &gt; 0.05). Furthermore, no significant differences were observed in the LEMG results of the non-paralyzed sides in IVCP patients, irrespective of the paralyzed side or the duration of the disease course (P &gt; 0.05), and no significant differences of the LEMG results were observed when comparing the non-paralyzed sides of patients with IVCP to the ipsilateral sides of healthy volunteers (P &gt; 0.05). However, when the disease course is less than 3 months, the amplitudes of the SLN and CM in the non-paralyzed side (right side) of left-sided IVCP patients are significantly lower than those in the non-paralyzed side (left side) of right-sided IVCP patients (SLN, 6.23 ± 4.42 mv vs. 10.21 ± 7.56 mv, t=-2.296, P = 0.028; CM, 0.49 ± 0.17 mv vs. 0.60 ± 0.19 mv, t=-2.207, P = 0.032), of which the amplitude of the CM is significantly reduced compared to the right side of healthy controls (0.49 ± 0.17 mv vs. 0.61 ± 0.21 mv, t=-2.423, P = 0.019), indicating that the SLN and CM on the non-paralyzed side are vulnerable to damage. Moreover, in patients with right-sided IVCP persisting for more than 3 months, there was a significant reduction in the amplitudes of the SLN and RLN, as well as the TM and PCM on the non-paralyzed side (left side), compared to the corresponding ipsilateral sides in healthy volunteers (P &lt; 0.05). This ","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791427","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":"Conventional curettage adenoidectomy vs endoscopic microdebrider adenoidectomy - A comparative study.","authors":"Amit Sharad Kole, Sharad Sachin Nilakhe, Shashikant Narayan Dorkar, Indranil Basu","doi":"10.1007/s00405-024-09037-6","DOIUrl":"https://doi.org/10.1007/s00405-024-09037-6","url":null,"abstract":"<p><strong>Background: </strong>Adenoidectomy is a frequently done ENT procedure. The purpose of the current article is to assess endoscopic powered adenoidectomy as a potential replacement for the traditional curettage approach.</p><p><strong>Methods: </strong>Two hundred forty consecutive adenoidectomy cases were randomly divided into two groups of one hundred twenty each. Between August 2020 to February 2023 after getting ethical clearance from Institutional Ethical Committee, Group I underwent Conventional Curettage Adenoidectomy (CA), while Group II underwent Endoscopic Micro-debrider Adenoidectomy (EMA).</p><p><strong>Results: </strong>Average operative time in CA Group was 31.4 min and in EMA group was 55.7 min. In CA group, mean intraoperative blood loss was 64.4 mL, however, in EMA group, mean blood loss was 86.7 mL (p 0.001). In EMA Group, the resection was consistently complete, with 112 out of 120 cases having an adenoid grade of less than I in post-op. However in the CA group, in 44 (36.7%) of the patients, there was more than 25% remaining adenoid tissue postoperatively and more than 50% remnant adenoid tissue was found in 12 cases (10%) post-op. Post-operative pain was studied with the CA Group demonstrating an average 7 days' postoperative pain score of 3.90 whereas EMA Group demonstrating an average 7 days' postoperative pain score of 0.9.</p><p><strong>Conclusions: </strong>It was observed that EMA was a secure and reliable tool for adenoidectomy. Endoscopic powered adenoidectomy performed better in the completion of resection, accuracy of resection under vision, collateral damage, and post-operative pain. Contrarily, conventional Curettage adenoidectomy scored higher in terms of shorter surgery times and less intraoperative hemorrhage.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791371","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":"Efficacy of enhanced dysphagia assessment and dietary intervention in post-stroke dysphagia patients: a randomized controlled study.","authors":"Shuai Wang, Junyan Feng, Juan Bi, Xiaoyan Li, Jundan Tian, Bingqian Zhang","doi":"10.1007/s00405-024-09112-y","DOIUrl":"https://doi.org/10.1007/s00405-024-09112-y","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the effectiveness of an enhanced dysphagia assessment method combined with dietary interventions for patients experiencing dysphagia post-stroke.</p><p><strong>Methods: </strong>A prospective randomized controlled trial was conducted with 98 hospitalized post-stroke patients suffering from dysphagia. Participants were randomly assigned into two groups: the study group (receiving enhanced dysphagia assessment and dietary interventions) and the control group (receiving standard nursing care), using a computer-generated randomization list. Swallowing function was assessed using the Mann Assessment of Swallowing Ability (mMASA), Dysphagia Severity Scale (DSS), and Wada's water swallowing test. Additionally, quality of life and nutritional status were evaluated for both groups, before and after the intervention.</p><p><strong>Results: </strong>Post-intervention, the study group exhibited significantly better scores on mMASA and Wada's water swallowing test, and lower DSS scores compared to the control group (all P < 0.05). Initially, no significant differences were observed between the groups concerning aspiration symptoms, nutritional and respiratory dysfunction, psychological disorders, and total scores (all P > 0.05). However, post-intervention, the study group showed significant improvements in these parameters and lower scores compared to the control group (all P < 0.05). Additionally, the study group demonstrated higher BMI, albumin (ALB), and hemoglobin (Hb) levels post-intervention (all P < 0.05), and a markedly lower incidence of aspiration and aspiration pneumonia (all P < 0.05).</p><p><strong>Conclusion: </strong>Enhanced dysphagia assessment combined with dietary interventions significantly improves swallowing function, quality of life, and nutritional status in post-stroke dysphagia patients. This approach also reduces the incidence of related complications, suggesting substantial clinical benefits.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784574","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 sinus surgery completeness score: a radiological assessment of the extent of endoscopic sinus surgery.","authors":"Keshav Kumar Gupta, Saleh Okhovat, Rishi Sharma, Alison Lim, Thomas Beech, Lisha McClelland, Arif Janjua, Karan Jolly","doi":"10.1007/s00405-024-09110-0","DOIUrl":"https://doi.org/10.1007/s00405-024-09110-0","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic rhinosinusitis (CRS) often requires endoscopic sinus surgery (ESS) for symptom control. However, there is currently a high reported revision rate. The introduction of biologics offers an alternative treatment, but patient criteria are ambiguous, particularly regarding the definition of \"previous ESS.\" This study aims to introduce the Sinus Surgery Completeness Score (SSCS) to help evaluate the extent of ESS as well as evaluate the extent of sinus surgery in the study cohort.</p><p><strong>Methods: </strong>The SSCS was developed by expert rhinologists and anterior skull base surgeons and applied to computed tomography (CT) sinus scans of 41 CRS patients who underwent previous ESS. Inter-rater reliability was assessed, and statistical analysis was performed to correlate SSCS scores with Lund-Mackay (LM) and Sinonasal Outcome Test-22 (SNOT-22) scores.</p><p><strong>Results: </strong>The SSCS demonstrated strong inter-rater reliability (Fleiss Kappa score 0.857). The mean time to complete the SCSS was 2.7 min. Most patients had incomplete surgery with a mean SCSS of 7.40 (total 24) with no patients achieving a maximum score. The maxillary sinus was the most dissected subunit, with frontal and sphenoid sinuses being the least. Weak negative correlations were observed between the SSCS and LM and SNOT-22 scores.</p><p><strong>Conclusions: </strong>The SSCS is a useful tool for assessing the completeness of sinus surgery, offering a standardized approach to evaluating surgical outcomes. While further research is needed to elucidate the relationship between surgical completeness and patient outcomes, the SSCS holds promise in guiding patient management including informing decisions regarding eligibility for biologic therapy.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767578","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":"Cervical lymph node dissection fails to improve survival in T2N0M0 glottic squamous cell carcinoma: a large-scale real-world study.","authors":"Zhuqi Chen, Xinyu Zhang, Wenbin Lei, Lin Chen","doi":"10.1007/s00405-024-09124-8","DOIUrl":"https://doi.org/10.1007/s00405-024-09124-8","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the therapeutic efficacy of cervical lymph node dissection in patients with T2N0M0 glottic squamous cell carcinoma.</p><p><strong>Methods: </strong>Among 260,068 head and neck cancer patients, 861 cases of T2N0M0 glottic squamous cell carcinoma were selected, of which 113 underwent selective lymph node dissection, and 748 did not receive dissection. The overall survival rates and disease-specific survival rates were compared between the two groups to assess efficacy.</p><p><strong>Results: </strong>There was no significant difference in overall survival rates (median survival time of 57 months vs. 62 months, p = 0.34) and disease-specific survival rates (p = 0.79) between the two groups. Patients aged ≥ 60 years were at a higher risk, whereas neck dissection, gender, and degree of differentiation did not show significant risk differences in this study.</p><p><strong>Conclusion: </strong>Cervical lymph node dissection in patients with T2N0 glottic squamous cell carcinoma did not demonstrate a significant advantage in survival rates.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767565","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":"Bilateral vocal cord paralysis in intermediate syndrome: a rare clinical presentation of organophosphorus poisoning.","authors":"P G Greeshma, T Kiran, Kiran M Naik, J Tej Pavan, M P Aswathy, A R Raghavendra, R Abhirami Krishnan","doi":"10.1007/s00405-024-09103-z","DOIUrl":"https://doi.org/10.1007/s00405-024-09103-z","url":null,"abstract":"<p><p>Organophosphorus poisoning poses a significant health threat, often resulting in high mortality and disability. The intermediate syndrome, characterized by muscle weakness in neck flexors and limbs, is prevalent. While uncommon, cases of vocal cord paralysis have been observed. Recognition and early management of such neurological complications are crucial for optimal patient care.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767564","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":"Etiology and therapy of pharyngeal perforations.","authors":"Givi Magradze, Andreas Knopf, Christoph Becker, Manuel Christoph Ketterer","doi":"10.1007/s00405-024-09115-9","DOIUrl":"https://doi.org/10.1007/s00405-024-09115-9","url":null,"abstract":"<p><strong>Objective: </strong>The primary aim of this study is to evaluate the impact of diagnostic procedures and treatment interventions performed at our medical institution on the final outcomes and survival rates of patients with iatrogenic and traumatic pharyngeal perforation (PP).</p><p><strong>Materials and methods: </strong>We reviewed the medical records of 36 patients with iatrogenic and trauma-induced PP who were treated at the Quaternary Medical Center of Otorhinolaryngology between 2010 and 2020. Comorbidities were classified according to the Age-adjusted Charlson Comorbidity Index (ACCI) scoring system, and postoperative complications were classified according to the Clavien and Dindo scoring system.</p><p><strong>Results: </strong>Of the 36 patients, 15 (41.7%) were male and 21 (58.3%) were female. The median age was 73 years, and PP was typically diagnosed within one day. Notably, the perforation site was identified in the hypopharynx in 29 (80.5%) patients. The median ACCI score was 4, with the most frequent ACCI score observed being 5. During the treatment course, 17 patients (47.2%) experienced complications, with 9 of these patients experiencing grade IV complications according to the Clavien and Dindo classification.</p><p><strong>Conclusion: </strong>Our study showed that patients with hypopharyngeal perforations have an almost 42-fold higher risk of mortality during hospitalization compared to those with epipharyngeal or oropharyngeal perforations, though results are limited by the small sample size and the variable dates. Additionally, neurosurgery of the cervical spine, transesophageal echocardiography, and diverticular surgery emerged as procedures carrying the highest risk for pharyngeal perforations. Within our patient cohort, 4 patients (11.11%, all female) died during the treatment course.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767566","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":"Nasal breathing: a neglected factor in metabolic regulation?","authors":"Francisco Alves de Sousa, João Tavares Correia, Miguel Gonçalves Ferreira, Marta Rios, Manuel Magalhães, Mariline Santos","doi":"10.1007/s00405-024-09093-y","DOIUrl":"https://doi.org/10.1007/s00405-024-09093-y","url":null,"abstract":"<p><strong>Purpose: </strong>Nasal breathing (NB) is a fundamental physiological process, and emerging research indicates its potential role in modulating resting metabolism, impacting energy expenditure and metabolic efficiency. This study investigates the impact of NB on resting metabolic rate (RMR), offering novel insights into metabolic regulation.</p><p><strong>Methods: </strong>A prospective study was conducted on patients undergoing nasal surgery, with measurements taken before and 3 months after surgery. Metabolic rate assessments, anthropometric dimensions, and peak nasal inspiratory flow (PNIF) were recorded. Factors like age, sex, and health status were considered to control for confounding variables.</p><p><strong>Results: </strong>A total of 83 patients were initially enrolled: 17 underwent septorhinoplasty (SRP), 61 septoplasty (ST) and 5 inferior turbinate reduction alone. 72 patients completed the follow-up. SRP patients exhibited significantly higher pre- and post-operative RMR compared to ST patients (p = 0.005), and this association was not observed when PNIF was included in the analysis (p > 0.05). Pre-operative and post-operative PNIF values significantly correlated with pre-operative and post-operative RMR (p = 0.049 and p = 0.005, respectively). Post-operative PNIF predicted post-operative RMR after confoundment adjustment in linear regression (β = - 0.043, p = 0.017). Importantly, total body weight increased after surgery (pre-op: 74 ± 14.6 kg versus post-op: 75.6 ± 15.5 kg, p < 0.001) due to an increment in muscle mass (pre-op: 52.3 ± 12 versus post-op: 55.5 ± 14, p < 0.01).</p><p><strong>Conclusion: </strong>Preliminary analysis suggests a potential link between NB and RMR, emphasizing the overlooked role of nasal respiratory physiology in energy homeostasis. Surgery also elicited body composition alterations. Further research is needed to uncover the underlying mechanisms of this association. Understanding the impact of NB on RMR could underscore its significance in metabolic regulation, reinforcing the importance of nasal surgery on overall health. This study provides foundation for future investigations.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767576","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 Lamella Ostium Extent Mucosa (LOEM) system: a new classification and pilot study for endoscopic sinus surgery.","authors":"Serafin Sanchez-Gomez, Daniel Martin-Jimenez, Ramon Moreno-Luna, Juan Maza-Solano, Christian Calvo-Henriquez, Alfonso Del Cuvillo, Jose M Villacampa-Auba, Alfonso Santamaria-Gadea, Ainhoa Garcia-Lliberos, Alvaro Sanchez-Barrueco, Gabriel Martinez-Capoccioni, David Lobo-Duro, Jaime Gonzalez-Garcia, Jose Palacios-Garcia, Rafael Fernandez-Liesa, Isam Alobid, Manuel Bernal-Sprekelsen","doi":"10.1007/s00405-024-09092-z","DOIUrl":"10.1007/s00405-024-09092-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study proposes the Lamella Ostium Extent Mucosa (LOEM) system as a compact and user-friendly classification for endoscopic sinus surgery (ESS), based on surgical bone extension and mucosal management, aiming to resolve inconsistencies in describing surgical techniques and extension levels, and to enhance comparability of outcomes in chronic rhinosinusitis (CRS).</p><p><strong>Methods: </strong>LOEM uses a lettering system representing a specific topographical level: L identifies the lamellae, O the ostia, E the opening of the sinus walls, and M the mucosal approach. Eleven CRS surgical cases were independently evaluated by seven rhinologists following a Delphi method in two consecutive rounds. Consensus was assessed using Cohen's kappa.</p><p><strong>Results: </strong>A substantial agreement was found among the experts (κ = 0.77) in the first round, although the M item only showed fair agreement (κ = 0.37). Clarifications for this item were given in the second round, after which, the overall agreement increased to κ = 0.81 and to κ = 0.79 for the M item. A decrease in agreement from substantial to moderate for O and E items in the second round was found. Test-retest analysis showed an almost perfect agreement (92.96%, κ = 0.82). In this study, a web-based app is provided to assist with the regular use of the LOEM system.</p><p><strong>Conclusions: </strong>The LOEM system provides a compact, comprehensive code for ESS, integrating anatomical and functional aspects to represent surgical techniques described so far. This system may be suitable for facilitating communication between surgeons and collecting robust labeled data, hopefully leading to further standardization and validation of surgical approaches in future CRS studies.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767577","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}