European Archives of Oto-Rhino-Laryngology最新文献

{"title":"Subtotal petrosectomy in cochlear implantation: Gruppo Otologico experience after 348 cases.","authors":"Luca Morelli, Sachin K Damam, Hailu Yilala M, G Fancello, M Ferraro, A Caruso, M Sanna","doi":"10.1007/s00405-025-09431-8","DOIUrl":"https://doi.org/10.1007/s00405-025-09431-8","url":null,"abstract":"<p><strong>Objective: </strong>To discuss indications (unfavorable conditions), surgical steps, complications, and follow-up of subtotal petrosectomy (STP) in cochlear implantation based on our experience of 348 cases. Anatomical variations associated with or without cochlear malformations and differences between electrode insertions were included in our analysis.</p><p><strong>Materials and methods: </strong>A retrospective case study was done in Gruppo Otologico (Piacenza, Italy), a quaternary referral center. Among 1002 cases that underwent subtotal petrosectomy, 348 were selected for cochlear implantation in the same setting. The study period was from 2004 to 2019. These patients' clinical and radiological follow-up ranged from 2 months to 180 months. Data were inspected, cleaned, and analyzed by SPSS software.</p><p><strong>Results: </strong>The selected group's mean age was 57.236 years, including 178 male and 170 female patients. The follow-up period lasted up to 108.65 months. Out of 348 cases, 8 were children (under the age of 18 years old). Inclusion criteria to be eligible for cochlear implantation in the same setting of subtotal petrosectomy was a preoperative pure tone average (PTA) of more than 90 decibels associated with low speech discrimination ranging from 0% in most cases up to 50% in the minority. 329 patients had a complete electrode insertion intra-operatively. Minor complications were observed in 6 cases. These include one case of implant extrusion due to a middle ear infection leading to labyrinthitis, three cases of post-auricular fistula causing one device failure, one subcutaneous CSF collection, and one subcutaneous seroma collection.</p><p><strong>Conclusion: </strong>Although in most cases, standardized trans mastoid facial recess technique for cochlear implantation is ideal as the surgical risks are minimal, in complicated cases such as concomitant chronic otitis media, prior canal wall-down cases, radical cavities, or inner ear abnormalities with high risk of cerebrospinal fluid leak subtotal petrosectomy should be the first choice of management with complete disease clearance. Close clinical and radiological follow-up is therefore mandatory. Single-stage implantation is preferred to staging the procedure unless one is unsure of disease clearance.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076846","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":"Integration of five electrophysiological test results for predicting outcome of patients with Bell's Palsy.","authors":"Min Young Heo, Seongmin Choi, Ga Yang Shim, Yunsoo Soh, Jinmann Chon, Myung Chul Yoo","doi":"10.1007/s00405-025-09419-4","DOIUrl":"https://doi.org/10.1007/s00405-025-09419-4","url":null,"abstract":"<p><strong>Purpose: </strong>To integrate the results from multiple electrophysiological tests, which has the potential to significantly improve outcome predictions in patients with Bell's palsy.</p><p><strong>Methods: </strong>This retrospective study analyzed 193 patients who were diagnosed with Bell's palsy at our Department of Physical Medicine & Rehabilitation, from January 2020 to December 2022. All patients were followed for at least 6 months, with a mean follow-up duration of 6.8 months (range: 6-9 months). Clinical data, including House-Brackmann (H-B) grade and electrophysiological data from five tests, were analyzed using multiple logistic regression analysis and decision tree analysis to predict outcome at 6 months. The five electrophysiological tests were: electroneurography degeneration index (ENoG DI), compound muscle action potential (CMAP) latency, blink reflex (BR), nerve excitability test (NET), and needle electromyography (nEMG).</p><p><strong>Results: </strong>The decision tree model identified five key predictors of recovery: ENoG DI in the orbicularis oculi, initial H-B grade, interference pattern in orbicularis oculi, NET difference, and CMAP latency in the frontalis. Patients with an ENoG DI < 71.72% and initial H-B grade ≤ 3 had a high probability of complete recovery. For higher ENoG DI values, a NET difference ≥ 4.50 mA and CMAP latency > 3.80 ms predicted incomplete recovery. This analysis led to an overall accuracy of 86.01%.</p><p><strong>Conclusion: </strong>This study demonstrated that the combined use of initial H-B grade with the results from multiple electrophysiological results provided reliable outcome predictions in patients with Bell's palsy.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076844","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":"A novel method of finding accessory nerve during head and neck surgery.","authors":"G Ozyigit, H B Cobanoğlu, S Arslan, A F Ozyasar, O Bahadır, A U Isik","doi":"10.1007/s00405-025-09393-x","DOIUrl":"https://doi.org/10.1007/s00405-025-09393-x","url":null,"abstract":"<p><strong>Introduction and purpose: </strong>In this prospective study, we performed neck morphological measurements and the relationship between the nerve and important anatomical structures in the neck to prevent spinal accessory nerve (SAN) damage in patients who underwent neck dissection.</p><p><strong>Methods: </strong>This study was conducted prospectively between October 2021 and September 2023 in 80 patients who underwent neck dissection due to head and neck malignancy.</p><p><strong>Results: </strong>The mean age of 59.2 ± 17.07 years (18-90 years) of the 80 patients, 54 were men and 26 were women. There was a positive correlation between the distance between the NAM-SAN and the sternocleidomastoid (Scm) muscle thickness(r = 0.242, p = 0.03). There was a positive correlation between the distance between the NAM-SAN and the distance between the mastoid apex and the clavicle midline (r = 0.235, p = 0.036). There was a statistically significant negative correlation between the distance between the NAM-SAN and age (r = - 0.324 p = 0.003). There was a positive correlation between the trapezius-SAN and the distance between the mandibula angulus-clavicle midline (r = -0.243 p = 0.03).</p><p><strong>Conclusion: </strong>The spinal accessory nerve must be sought for higher than the estimated point In patients which with more scm thickness. It should be considered that as the preoperatively measured mastoid apex-clavicle distance increases, the distance between the NAM and the SAN increases. It should be taken into consideration that the course of the SAN in the posterior triangle will be longer in patients with longer necks. It should be noted that as age increases, the distance between the SAN and NAM decreases.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959716","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":"Use of double flaps in pharyngo-laryngo-esophageal reconstructions: a retrospective review.","authors":"Andrea Sacchetto, Stefano Meneghesso, Marco Mazzola, Luca Sacchetto, Gabriele Molteni, Virginia Dallari","doi":"10.1007/s00405-025-09456-z","DOIUrl":"https://doi.org/10.1007/s00405-025-09456-z","url":null,"abstract":"<p><strong>Purpose: </strong>This article aims to review techniques and applications for using double flaps (both free and pedicled, and their combinations) in reconstructing defects from total pharyngolaryngectomies (TPL) or pharyngolaryngo-esophagectomies.</p><p><strong>Methods: </strong>This systematic review followed PRISMA 2020 guidelines. Three authors screened articles, selecting and extracting data on malignancy characteristics, reconstructive techniques, outcomes and complications.</p><p><strong>Results: </strong>Eleven articles were reviewed, involving 176 oncologic patients. Most patients (39.8%) had defects in the larynx, hypopharynx and cervical skin, while in 31.8% the double flaps were used to restore the pharynx and protect the visceral anastomosis. In most studies included, preoperative treatments were administered, including radiotherapy (RT), concurrent chemoradiotherapy (CRT), and surgery, either alone or in combination. A wide variety of pedicled and free flaps were described. The most common pedicled flap is the pectoralis flap (81 patients, 46%), while the most used free flap is the jejunum flap (124 patients, 70%). 19 patients (10.8%) manifested partial necrosis or encountered minor complications postoperatively. 5 patients necessitated a surgical revision of the flap.</p><p><strong>Conclusion: </strong>The literature on surgical reconstructions following TPL or pharyngolaryngo-esophagectomies using double flaps is limited. The use of double flap is indicated in cases of TPL with extensive skin defect but is also recommended in case of salvage TPL without skin defect.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987575","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":"A new classification scheme for laryngomalacia.","authors":"H Attya","doi":"10.1007/s00405-025-09434-5","DOIUrl":"https://doi.org/10.1007/s00405-025-09434-5","url":null,"abstract":"<p><strong>Objectives: </strong>To propose a novel classification method for assessing the severity of laryngomalacia (LM).</p><p><strong>Materials and methods: </strong>During a three-year period, all paediatric patients diagnosed with laryngomalacia were included. A disease-specific questionnaire consisting of eleven questions with four possible responses was administered to gather patient information, and a scoring system was utilized to classify the severity of their condition based on medical history and examination findings. Patients were assigned to two groups: group 1 included those having LM with no or mild co morbidities, group 2 included patients with severe co morbidities. Group 1 was further subdivided into three subgroups based on symptom scores [ (1a) with a score of 1-11, (1b) with a score of 12-22, and (1c) with a score of 23-33].</p><p><strong>Results: </strong>The study enrolled a total of fifty participants. Five individuals with laryngomalacia and severe comorbidities were placed in group 2, while the remaining forty-five participants were assigned to group 1. Initial assessment revealed that thirty-five participants were categorized in subgroup 1c and 10 in subgroup 1b. Individuals in subgroup 1c underwent supraglottoplasty and demonstrated an average 25% reduction in symptom scores at 6 weeks post-surgery.</p><p><strong>Conclusion: </strong>A severity-based classification system is proposed, and a management strategy is presented for laryngomalacia.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976558","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":"Tinnitus management by improving resilience using exposure in virtual reality: a scoping review.","authors":"Olav Wagenaar, Annick Gilles, Laure Jacquemin, Vincent Van Rompaey, Henk Blom","doi":"10.1007/s00405-025-09396-8","DOIUrl":"https://doi.org/10.1007/s00405-025-09396-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate effectiveness of Virtual Reality (VR) on tinnitus burden in adult patients, and which improvements can be implemented. Literature review focuses on VR's usability as a tinnitus management tool, and on comparison with standard care.</p><p><strong>Methods: </strong>Systematic search of PubMed and Google Scholar databases, covering articles from 2000 to 2024. We used MeSH terms \"VR,\" \"Virtual Reality,\" and \"3D immersion\" combined with \"tinnitus,\" applying filters for clinical trials and randomized controlled trials. In Google Scholar, the advanced search function was used. Only English peer reviewed articles were included. Studies were selected based on PICOS (Patient Intervention Comparison Outcome Study) criteria, including adult patients receiving VR therapy with outcomes measured by questionnaires.</p><p><strong>Results: </strong>Of the 17 initially identified articles, 10 remained after removing duplicates, and 2 studies were ultimately included for detailed review. Data extraction followed the PRISMA-ScR guidelines, with independent reviewers charting data. Primary outcomes included change in functional limitations, mood and distress. Results suggest beneficial findings of VR immersion equivalent to standard care. However, the clinical significance remains unclear due to small sample and effect sizes and short follow-up periods.</p><p><strong>Conclusions: </strong>VR therapy shows promise as a potential tool for managing tinnitus, particularly due to its independence from therapists and shorter treatment duration, while being as effective as usual care. Further research with larger sample sizes, extended follow-up periods and incorporation of minimal clinically important differences (MCID) is necessary to validate effectiveness and scalability as an intervention for tinnitus resilience enhancement. Suggestions are given for content optimization.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987337","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":"Translation, cultural adaptation and validation of the Stapesplasty Outcome Test 25 (SPOT-25) for measurement of disease-specific health-related quality of life in Dutch otosclerosis patients: a prospective study.","authors":"Esther E Blijleven, Maaike Jellema, Joeri Buwalda, Raphael J B Hemler, Huib F van Waegeningh, Robert J Stokroos, Hans G X M Thomeer, Inge Wegner","doi":"10.1007/s00405-025-09353-5","DOIUrl":"https://doi.org/10.1007/s00405-025-09353-5","url":null,"abstract":"<p><strong>Purpose: </strong>To translate and culturally adapt the SPOT-25 to the Dutch language and validate the Dutch SPOT-25 in a Dutch population of otosclerosis patients undergoing primary stapes surgery.</p><p><strong>Methods: </strong>A multicenter prospective validation study was performed between November 2018 and May 2024. The translation into Dutch and validation process of the SPOT-25 was performed according to the COSMIN guidelines. Patients were asked to complete the SPOT-25 and Glasgow Health Status Questionnaire (GHSQ) preoperatively, the SPOT-25, GHSQ and Glasgow Benefit Inventory six to eight weeks postoperatively and the SPOT-25 eight to ten weeks postoperatively. Healthy controls were asked to complete the translated SPOT-25 once. Preoperative and postoperative audiometric results were also obtained. The evaluated measurement properties included construct validity, measurement invariance, discriminative validity, reliability and responsiveness of the translated SPOT-25.</p><p><strong>Results: </strong>Hundred and fifteen patients and 50 healthy controls were analyzed. Analyses of the translated SPOT-25 showed adequate construct validity, discriminative validity, reliability and responsiveness. The SPOT-25 scores were strongly correlated with the GHSQ score. The internal consistency and test-retest reliability were good as Cronbach's alpha and intraclass correlation coefficients were higher than 0.70. The four-factor model fitted best in our population of otosclerosis patients; however the results indicated a mediocre fit between the model and the data.</p><p><strong>Conclusion: </strong>The Dutch SPOT-25 showed good validity, reliability and responsiveness and can be implemented as an additional outcome measure to improve otosclerosis research and clinical practice.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997135","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":"Dysphagia from an aberrant internal carotid artery: a case report.","authors":"Marie Bjerg Larsen, Pádraig O'Leary","doi":"10.1007/s00405-025-09417-6","DOIUrl":"https://doi.org/10.1007/s00405-025-09417-6","url":null,"abstract":"<p><strong>Purpose: </strong>We present a case of dysphagia caused by an aberrant internal carotid artery (ICA). By reporting this rare occurrence, we hope to highlight the anomaly as a differential in cases of persistent, progressive dysphagia.</p><p><strong>Results: </strong>Even though the symptomatic mass effect of the ICA warranted the option of surgical intervention, due to a patient-centered approach with an emphasis on personal preference, the patient was instead referred for specialized ergotherapy.</p><p><strong>Conclusion: </strong>This case characterizes a rare yet significant cause of dysphagia, in addition, it illustrates the necessity of a multidisciplinary approach when dealing with complex cases of dysphagia.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977254","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":"Seasonal and monthly variation in benign paroxysmal positional vertigo: a systematic review and meta‑analysis.","authors":"Linlin Wang, Haixia Wang, Hui Pan, Wen Xie, Peixia Wu, Bo Liu","doi":"10.1007/s00405-025-09422-9","DOIUrl":"https://doi.org/10.1007/s00405-025-09422-9","url":null,"abstract":"<p><strong>Purpose: </strong>The relationship between seasonal variations and the incidence of benign paroxysmal positional vertigo (BPPV) has been widely studied, but the findings remain inconsistent. This systematic review and meta-analysis aimed to evaluate whether BPPV demonstrates seasonal variation.</p><p><strong>Methods: </strong>A comprehensive search was conducted across PubMed, Embase, Cochrane Library, Web of Science, and CNKI databases for studies on the monthly or seasonal incidence of BPPV from their inception up to August 2024. Pooled monthly or seasonal incidence rates, risk ratios (RRs) for one season versus another and 95% confidence intervals (CIs) were combined using the random-effects model. This meta-analysis has been registered at International Prospective Register of Systematic Reviews (PROSPERO) (NO. CRD42024583513).</p><p><strong>Results: </strong>Ten eligible studies were included, comprising 5,063 subjects. Pooled BPPV incidence was highest in winter (28%) and lowest in summer (21%). Additionally, the pooled monthly incidence was highest in December (12.6%) and lowest in July (7.4%). The overall RRs and 95% CIs are as follows: winter versus summer (1.30 [1.07,1.59]); winter versus spring (1.01 [0.88,1.17]); winter versus autumn (1.11[0.95,1.30]); spring versus autumn (1.09 [0.91,1.31]); spring versus summer (1.29 [1.00,1.66]); autumn versus summer (1.17 [0.97,1.42]).</p><p><strong>Conclusion: </strong>Our meta-analysis suggests that there may be seasonal variation in the incidence of BPPV. The finding of seasonal patterns provides a new perspective to our understanding of BPPV, suggesting environmental factors may play a potential role in its pathophysiology. However, larger cohort studies and multicenter datasets are warranted to validate these findings in future research.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001652","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":"Effectiveness of aerobic exercise training in patients with obstructive sleep apnea: a systematic review and meta-analysis.","authors":"Mrudula Pawar, Prem Venkatesan, Satyanarayana Mysore, Guruprasad Bhat","doi":"10.1007/s00405-025-09436-3","DOIUrl":"https://doi.org/10.1007/s00405-025-09436-3","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA), a sleep-related disorder, reports significant clinical consequences, apart from its socioeconomic burden globally. Among the physiotherapeutic treatment options, exercise training is primarily preferred for these patients. In the current systematic review and meta-analysis, we hypothesize that aerobic exercise training could be beneficial in reducing the severity of OSA.</p><p><strong>Methods: </strong>A thorough literature search was carried out from Scopus, PubMed, CINAHL, Cochrane, and Embase databases following the PRISMA guidelines, and eight studies were included. The primary outcome was the apnea hypopnea index (AHI) and secondary outcomes were maximal oxygen consumption, oxygen desaturation index, mean oxygen saturation during sleep, Epworth sleepiness scale, body mass index, and neck circumference. RevMan version 5.4.1 was utilized for analysis.</p><p><strong>Results: </strong>Meta-analysis involved seven studies that showed that aerobic training significantly improved the AHI with a mean difference of -5.24 and an overall effect of p < 0.00001; and VO_2max with a mean difference of 5.84 and an overall effect of p = 0.03. The other secondary outcomes reported improvement but were not significant.</p><p><strong>Conclusion: </strong>The current review concludes that there is supporting evidence for the beneficial effects of aerobic exercise training in reducing the severity of obstructive sleep apnea.</p><p><strong>Prospero registration: </strong>CRD42023453316.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978132","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}