European Archives of Oto-Rhino-Laryngology最新文献

{"title":"Slide laryngotracheopexy for idiopathic subglottic stenosis.","authors":"Zoltán Tóbiás, Ádám Bach, László Szakács, Miklós Csanády, Andrea Ambrus, László Rovó","doi":"10.1007/s00405-025-09226-x","DOIUrl":"10.1007/s00405-025-09226-x","url":null,"abstract":"<p><strong>Objectives: </strong>Idiopathic subglottic stenosis (iSGS) is a rare fibroinflammatory disorder characterized by scar tissue formation in the subglottic and tracheal regions. This study evaluated the long-term outcomes of a novel, single-step surgical technique that redefines the glottic and subglottic airway using local tracheal grafts.</p><p><strong>Methods: </strong>Thirteen patients (2 male and 11 female) diagnosed with iSGS who underwent slide laryngotracheopexy were enrolled in this study. The diagnosis of iSGS was confirmed through endoscopic assessment, CT scanning, and autoimmune blood testing. Patients completed post-operative Voice Handicap Index (VHI), Quality of Life (QoL), and MD Anderson Dysphagia Inventory (MDADI) questionnaires, and spirometry assessments were conducted.</p><p><strong>Results: </strong>All patients were successfully extubated in the operating room following surgery. None of the patients required intensive care unit treatment. The average hospital stay was 14 days. A temporary tracheotomy was needed in one case because of excessive crusting. Adjuvant endolaryngeal laser surgery was performed in three cases. In one case, mitomycin-C therapy was administered to treat granulation. Post-operative quality of life (QoL) assessment, peak inspiratory flow (PIF), and scores from the MDADI and VHI questionnaires were 9.0 (± 2.2), 2.8 l/s (± 0.83), 95.6 (± 4.3), and 18.7 (± 13.4), respectively.</p><p><strong>Conclusion: </strong>Slide laryngotracheopexy was a safe and dependable technique for cases classified as Cotton-Myers II-IV grade iSGS. The use of a tracheal flap was advantageous to ensure optimal mucosal function. Slide laryngotracheopexy may be employed following multiple endolaryngeal interventions, whereas adjuvant CO₂ laser surgery or mitomycin-c therapy may be considered in cases involving granulation tissue formation.</p><p><strong>Level of evidence: 4: </strong></p><p><strong>Study design: </strong>Retrospective case series review.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1981-1988"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-centred outcome following endoscopic management of benign central airway obstruction.","authors":"Mads Bøgh, Dalia Gustaityté Larsen, Matilde Lonka, Sten Schytte, Ulrik Pedersen, Søren Gade, Padraig O'Leary, Thomas Kjaergaard","doi":"10.1007/s00405-025-09230-1","DOIUrl":"10.1007/s00405-025-09230-1","url":null,"abstract":"<p><strong>Purpose: </strong>To examine patient-centred outcome following endoscopic treatment of central airway stenosis in terms of days alive and out of hospital (DAOH), need for re-intervention, and complications, with reference to aetiology of disease and applied treatment methodology.</p><p><strong>Methods: </strong>Analyses were based on data from consecutive adult patients treated endoscopically for benign central airway obstruction at Aarhus University Hospital from 2012 to 2022, with a minimum follow-up of one year. DAOH was calculated for 30 and 365 days. Complications were graded based on the Clavien-Dindo classification. Univariate and multivariate analyses were performed to identify predictors for DAOH, re-intervention and complications.</p><p><strong>Results: </strong>82 consecutive adult patients underwent endoscopic treatment during the period of inclusion, comprising a total of 175 dilatations, 42 benign tumour resections, and 67 stent insertions. Multiple interventions and short re-intervention intervals was more likely amongst patients reporting significant preoperative dyspnoea or requiring preoperative respiratory support, as well as patients treated with endoscopic insertion of silicone stents. The overall complication rate per procedure was 11.7%, and complications were more likely to occur in patients with high age, high BMI and comorbidity. Overall DAOH during the first year after intervention was 343 days, lowest amongst patients with tracheobronchomalacia or severe airway stenosis, and in those who underwent endoscopic stent insertion.</p><p><strong>Conclusion: </strong>Endoscopic treatment is a safe and viable intervention in the management of benign central airway obstruction in adults with few complications and a high overall outcome.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"2001-2007"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-year long-term functional and quality of life outcomes in total glossectomy survivors.","authors":"Hemant Nemade, Abhinav Thaduri, Jonathan T Gondi, Sravankumar Chava, Anil Kumar, Pratheek Raj, Uma Neelap, Pardhasaradhi Akalankam, T M Rukmangatham, L M Chandra Sekara Rao S","doi":"10.1007/s00405-024-09059-0","DOIUrl":"10.1007/s00405-024-09059-0","url":null,"abstract":"<p><strong>Background: </strong>Total glossectomy is proven to be a superior treatment option for advanced tongue cancer. Despite its efficacy, the procedure is associated with profound morbidity, notably impacting Speech, swallowing, and overall quality of life. Limited therapeutic benefits and the potential for considerable morbidity render total glossectomy a subject of controversy.</p><p><strong>Methods: </strong>We performed a multidimensional quality of life evaluation of long-term (more than 5 yrs.) total glossectomy survivors. In this study, we evaluated 25 total glossectomy survivors with comprehensive functional and quality of life outcomes using objective measures (London Speech Evaluation Scale, FOIS, 100 ml Water Challenge, FEES) and Patient-reported outcomes (SHI, PSS HN, EORTC QLQ 30 & HN35).</p><p><strong>Results: </strong>EORTC QLQ 30 showed overall good global health status (M = 80 ± 20) and functional scale mean scores ranging from 87 to 91, despite issues in pain (M = 31.6 ± 31), swallowing (M = 23.3 ± 24), and Speech (26.1 ± 1). Speech outcomes revealed 80% with moderate to severe intelligibility impairment. Swallowing outcomes showed 84% requiring special food preparation, 24% exhibiting aspiration, and 72% having pharyngeal residue. Speech outcomes showed 88% having moderate-severe speech impairment, and Patient-reported speech outcomes indicated a mean SHI score of (M = 47.2 ± 42).</p><p><strong>Conclusion: </strong>Patients undergoing total glossectomy report favourable long-term outcomes in global health-related quality of life despite moderate to severe impairments in objective speech and swallowing evaluations. These positive patient-reported outcomes support the consideration of total glossectomy as a viable treatment option if and when required, underscoring the importance of evaluating treatment outcomes through the patient-perceived quality of life.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"2063-2070"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603079","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":"Staggered botulinum toxin-a injections into parotid and submandibular glands prior to four-duct ligation for pediatric sialorrhea.","authors":"Omer Faruk Calim, Emre Polat, Orhan Ozturan","doi":"10.1007/s00405-024-09022-z","DOIUrl":"10.1007/s00405-024-09022-z","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the effectiveness of four-duct ligation following Botulinum toxin-A injections into the parotid and submandibular glands in pediatric patients with sialorrhea resistant to nonsurgical treatments. Prior research has individually explored either surgical or Botulinum toxin interventions; however, the safety and efficacy of the combined approach to these treatments have yet to be documented.</p><p><strong>Methods: </strong>Patients were assessed before surgery and 6, 12, and 24 months post-operatively. Evaluations involved interviews with parents and caregivers, conducted face-to-face or by telephone, using the Drooling Severity and Frequency Scales. Additionally, metrics such as the daily count of bib changes and the hourly frequency of saliva wiping were recorded. Quality-of-life assessments were performed before and after the surgical procedures. All complications associated with the interventions were carefully recorded.</p><p><strong>Results: </strong>The study group consisted of 25 participants, with a median age of 6 years (range 2-17 years). Each participant was diagnosed with a neurological, metabolic, or genetic disorder. Evaluations were conducted periodically, culminating in a final follow-up at 24 months. The treatment demonstrated a 100% success rate at six months post-operation (25/25 patients), which slightly decreased to 96% at the 12-month mark (24/25 patients) and further to 84% by the 24-month follow-up (21/25 patients). Major complications were not observed. However, minor complications were reported in six patients (24%): three exhibited temporary facial swelling (12%), two encountered minor bleeding (8%), and one experienced excessive dryness (4%).</p><p><strong>Conclusions: </strong>The combination of Botulinum toxin-A injection 3 weeks prior to the four-duct ligation procedure demonstrated high success rates and substantially reduced the incidence of infectious and cosmetic complications. Consequently, this staggered approach to combination treatment is recommended for managing pediatric sialorrhea cases that are resistant to non-surgical interventions.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"2043-2051"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521441","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":"Mucosal integrity of the larynx and hypopharynx and the response to proton pump inhibitors in patients with laryngopharyngeal reflux.","authors":"Clara Mota Randal Pompeu, Thiago Meneses Araújo Leite Sales, Lucas Antonio Duarte Nicolau, Anna Caroline Rodrigues de Souza Matos, Aline Almeida Figueiredo Borsaro, Tanila Aguiar Andrade Coutinho, Larissa Freire Alves Nogueira, Fábio Rocha Fernandes Távora, Miguel Ângelo Nobre E Souza, Daniel Siffrim, Marcellus Henrique Loiola Ponte de Souza","doi":"10.1007/s00405-025-09214-1","DOIUrl":"10.1007/s00405-025-09214-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether impairment of integrity of laryngeal and hypopharyngeal mucosa in laryngopharyngeal reflux (LPR) could be related to response to proton pump inhibitors (PPIs).</p><p><strong>Methods: </strong>Chronic hoarseness with Reflux Finding Score (RFS) > = 7 was evaluated using the Reflux Disease Questionnaire (RDQ) and Reflux Symptoms Index (RSI). Upper endoscopy was performed and samples of the laryngeal posterior commissure were collected to evaluate ex vivo laryngeal mucosal integrity by transepithelial resistance (TER) using Ussing chamber. In vivo, hypopharyngeal integrity was measured using intraluminal impedance. Clinical responders scored < 13 and had a drop of at least 50% in the initial RSI after 8 weeks of pantoprazole.</p><p><strong>Results: </strong>Eighteen patients completed the protocol, Esophagitis was detected in 28% of the patients, and one patient presented acid exposure above 6%. After treatment, 66.67% responded to PPI. Laryngeal basal TER and TER drops after the weakly acidid challenge showed no difference between PPI responders and non-responders. Hypopharyngeal basal impedance was similar between the groups. After acid exposure test, there was a lower impedance in non-responders.</p><p><strong>Conclusion: </strong>In laryngopharyngeal reflux, hypopharyngeal mucosal integrity was lower in PPI non-responders. These preliminary results suggest that the weaker laryngopharyngeal mucosa in refractory LPR may require new therapies aimed at improving barrier function.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"2159-2164"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074278","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":"Long-term outcomes of surgical treatment for paediatric acute mastoiditis: the role of mastoidectomy.","authors":"Matija Švagan, Janez Rebol","doi":"10.1007/s00405-024-09072-3","DOIUrl":"10.1007/s00405-024-09072-3","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the declining incidence of acute mastoiditis (AM) due to antibiotics, complications persist, necessitating surgical intervention in severe cases. Recent studies suggest conservative treatments, avoiding mastoidectomy, show high recovery rates. However, this trend raises concerns about severe complications, prolonged treatment, increased antibiotic use, and declining surgical skills. While much research focuses on AM pathogenesis and treatment, the long-term consequences, especially post-mastoidectomy ear function, are less understood. To address this, we studied the permanent effects of surgically treated AM and mastoidectomy on ear function.</p><p><strong>Methods: </strong>A cohort of patients that received surgical treatment for AM in the form of mastoidectomy was invited to be tested after at least 5 years since the operation. Test battery included COMQ-12 questionnaire, physical exam and otomicroscopy, extended high pure tone audiogram, DPAOE and middle ear impedance testing. Results were compared with a control group and a group which received surgical treatment in the form of tympanostomy for acute otitis media with impeding mastoiditis.</p><p><strong>Results: </strong>The COMQ-12 questionnaire yielded higher scores in questions about hearing in quiet environments, hearing in noise, tinnitus, and ear discomfort. Minor structural changes were observed in the test groups during otomicroscopy, but not in the control group. Pure tone audiometry revealed a median elevation of around 10 dB in high and extended high frequencies, with similar results observed in DPAOE testing. In middle ear impedance testing, only an elevation of the stapedial reflex threshold was noted; other tests did not show any statistically significant differences.</p><p><strong>Conclusions: </strong>In the long term, the majority of patients post-AM have minor functional in structural consequences. In the context of treatment of AM, the effects of mastoidectomy are negligible when compared to less invasive surgical procedures.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1815-1823"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of hypertonic nasal spray with algae in rhinosinusitis.","authors":"Zeynel Öztürk, Nuray Bayar Muluk, Rahime Koca, Necdet Özçelіk, Elvin Alaskarov, İbrahim Çukurova, Erdem Atalay Çetіnkaya, Özgür Yörük, Cengiz Bal, Arzu Tatar, Nihat Susaman, Nagehan Dilşad Erdoğmuş Küçükcan, Ayten Güner Atayoğlu, Enes Güngör, Burak Mustafa Taş, Cemal Cingi","doi":"10.1007/s00405-025-09266-3","DOIUrl":"10.1007/s00405-025-09266-3","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to evaluate the effectiveness of nasal irrigation sprays at treating rhinosinusitis by easing congestion in the nose and other symptoms.</p><p><strong>Methods: </strong>A total of 1700 individuals diagnosed with rhinosinusitis were assigned to the following groups: One group used Sinomarin^® hypertonic nasal spray (n = 600), another used Sinomarin^® Plus Algae ENT hypertonic nasal spray (n = 600), and a third used an isotonic saline nasal spray (n = 500). Before and after therapy, patients had their symptoms and turbinates examined, overall symptoms scored, and quality of life (QoL) evaluated.</p><p><strong>Results: </strong>The findings showed that both groups saw a decrease in symptom scores for anterior discharge, postnasal drip, headache, and obstruction with therapy, as well as an improvement in turbinate color and edema (p < 0.05). Quality of life (QoL) ratings rose, and total symptom scores fell during therapy. The group that used hypertonic nasal spray with algae had considerably fewer overall symptom scores than the other groups (hypertonic nasal spray and saline). The hypertonic nasal spray group reported substantially fewer symptoms than the saline group. For what concerns quality of life, the saline group had significantly worse scores than groups 1 and 2; groups 1 and 2 were similar to one another.</p><p><strong>Conclusion: </strong>We found that compared to hypertonic and saline nasal sprays, the algae-containing hypertonic spray reduced total symptom scores more than the other sprays. This indicated that irrigation based on algae-containing hypertonic nasal sprays could be the treatment of choice for the management of symptoms in rhinosinusitis patients.</p><p><strong>Clinical trial number: </strong>The study was registered to ClinicalTrials.gov Protocol Registration and Results System (PRS) with a Clinical trial number of E-95961207-202.3.02-2955.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1963-1970"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemorrhage risk after coblation tonsillectomy in Chinese pediatric: a multicenter, prospective, observational cohort study.","authors":"Hongming Xu, Shuyao Qiu, Jinxia Wang, Fugen Han, Zhongfang Xia, Liyan Ni, Jing Ma, Chunguang Chen, Xingqiang Gao, Junmei Zhang, Haixia Liu, Haibing Liu, Hongbing Yao, Qianger Zhuang, Wei Song, Sijun Zhao, Dabo Liu, Xiaoyan Li","doi":"10.1007/s00405-024-09140-8","DOIUrl":"10.1007/s00405-024-09140-8","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to assess the incidence of post-coblation tonsillectomy hemorrhage (PCTH) and identify associated risk factors in a pediatric Chinese population.</p><p><strong>Methods: </strong>This prospective, multicenter cohort study, conducted over 17 months, included 8854 pediatric patients who underwent coblation tonsillectomy across 15 research centers in China. Patient data were collected through an Electronic Data Capture (EDC) system. The primary outcome was the incidence of PCTH within 21 days post-surgery. Secondary outcomes involved analyzing risk factors for PCTH using multivariable logistic regression.</p><p><strong>Results: </strong>The incidence of PCTH was 1.99%, with 176 patients experiencing hemorrhage. Significant risk factors included abnormal coagulation indicators (OR 10.56), longer surgery duration (OR 1.02), simultaneous adenoidectomy (OR 0.35), semi-liquid diet (OR 0.13), postoperative cough (OR 1.76), and the use of hemostatic agents (OR 1.58), intravenous antibiotics (OR 2.34), and painkillers (OR 2.33). Regional variations showed lower hemorrhage rates in East, Southwest, Central, and South China compared to North China.</p><p><strong>Conclusions: </strong>The study found that the hemorrhage rate after coblation tonsillectomy is comparable to traditional tonsillectomy. Risk factors include coagulation status, surgical duration, and postoperative care. Regional differences in hemorrhage rates suggest the need for tailored approaches based on location. Coblation tonsillectomy is a safe and effective procedure for pediatric patients. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION FOR PROSPECTIVELY REGISTERED TRIALS: This study was registered on Clinical trials.gov (NCT05206799), and approved by the Ethics Committee of Shanghai Children's Hospital, Shanghai Jiaotong University (2021R096-E01).</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1901-1909"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876264","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":"Impact of cochlear detailed morphology on insertion results and intracochlear trauma of a slim pre-curved electrode array: a micro-CT study.","authors":"Jiabao Mao, Linhan Huang, Zhangcai Chi, Min Chen, Wen Li, Shufeng Li","doi":"10.1007/s00405-024-09058-1","DOIUrl":"10.1007/s00405-024-09058-1","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the impact of detailed cochlear dimensions, assessed using micro-CT (µCT) imaging, on insertion outcomes and associated trauma with a new slim, precurved electrode array.</p><p><strong>Materials and methods: </strong>Eleven temporal bone specimens underwent implantation of a 22-electrode slim precurved array via the round window. High-resolution µCT scans post-implantation enabled visualization of cochlear structures and electrode positioning. Combination with subsequent scans taken after electrodes removal, we analyzed angular insertion depth (AID), insertion length, number of electrodes inserted, cochlear dimensions (specifically cochlear duct length (CDL), basal turn diameter, scala tympani dimension), and intracochlear trauma of fine structures. Statistical analyses were performed to correlate cochlear detailed dimensions and morphology with insertion outcomes and trauma.</p><p><strong>Results: </strong>The mean AID was 351.82°, and the mean insertion length was 21.07 mm. CDL showed positive correlations with AID and insertion length. Basal turn diameter (value B) positively correlated with AID and insertion length, unlike value A. Middle-basal turn (M/B) relationships (angle and height) significantly influenced insertion depth. The cochleae with smaller M/B heights and specific angles were more susceptible to insertion trauma. Larger basal turn diameters correlated with increased trauma and electrode translocation into the scala vestibuli.</p><p><strong>Conclusion: </strong>This study highlights the importance of precise cochlear measurements in predicting and optimizing cochlear implant outcomes. Specific cochlear dimensions and anatomical shapes were identified as critical factors affecting insertion depth, trauma risk, and electrode positioning. Utilizing micro-CT provided detailed insights into cochlear anatomy and insertion outcomes, offering valuable data for advancing cochlear implant technology and surgical practices.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"1769-1781"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564108","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":"Determination of optimal sedation depth in sleep endoscopy with bispectrometry and simultaneous polysomnography.","authors":"Öznur Gündüz, Kürşat Murat Özcan, Fatma Cemre Sazak Kundi, Ezgi Erkılıç, Selma Fırat","doi":"10.1007/s00405-024-09194-8","DOIUrl":"10.1007/s00405-024-09194-8","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we aimed to evaluate the localization and configuration of vibration and obstruction in drug-induced sleep endoscopy(DISE) in obstructive sleep apnea patients and to investigate the optimal sedation depth.</p><p><strong>Materials and methods: </strong>The study was conducted prospectively with 42 patients. After achieving sedation with intravenous anesthetic agents, simultaneous monitoring of the patient's bispectrometry (BIS), DISE and sleep testing with a type 2 polysomnography device were performed. DISE was performed using fentanyl and midazolam, followed by propofol administered with manually controlled infusion method. The recorded data were evaluated and subjected to statistical comparisons.</p><p><strong>Results: </strong>It was observed that as BIS values decreased, the frequency of decreased respiratory effort and desaturation increased. Central apneas were observed with BIS values below 65 and were found to increase with deeper sedation, while with BIS values above 70, all respiratory events were obstructive apneas, with retro-palatal obstruction being the most common. It was noted that vibration occurred in over 90% of patients within the BIS range of 60-70. It was decided that the optimal sedation depth for evaluating vibration and obstruction in sleep endoscopy was within the BIS range of 60-75.</p><p><strong>Conclusion: </strong>According to the results of our study, as sedation depth increases, the frequency of central apnea and desaturation increases. In our study, the sedation depth within the BIS 60-75 range was found to be the most suitable range for evaluating obstructive apnea and snoring.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"2141-2148"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970170","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}