Iranian Journal of Otorhinolaryngology最新文献

{"title":"Association of Deviated Nasal Septum as an Etiological Factor for Antrochoanal Polyp.","authors":"Sreelakshmi Muraleedharan, Marina Saldanha, Shibin Samson, Raghuraj Uppoor","doi":"10.22038/ijorl.2026.86472.3898","DOIUrl":"10.22038/ijorl.2026.86472.3898","url":null,"abstract":"<p><strong>Introduction: </strong>The etiology of Antrochoanal polyp (ACP) has been a subject of controversy. A deviated nasal septum may contribute to ACP formation by forcing a maxillary cyst through the accessory ostium. This study aims to evaluate the role of DNS in the formation of ACP.</p><p><strong>Materials and methods: </strong>This retrospective case-control study included 40 diagnosed ACP cases (Group A) and 40 asymptomatic controls (Group B). The imaging scans of 80 patients were retrieved from the database and reviewed to correlate septal deviation with ACP using three septal deviation classifications- Mladina classification, classification based on the location of most prominent point of septal deviation and Baumann classification.</p><p><strong>Results: </strong>In Group A, septal deviation was present in 92.5% of patients, with 55% showing left-sided ACP with left DNS and 37.5% right-sided ACP with right DNS. In the control group, septal deviation was present in 90% of patients. On comparing septal deviation and ACP using Mladina classification (p value = 0.098) and Baumann classification (p value=0.805), no statistical significance was observed. A statistically significant difference (p value <0.001) was observed between the cases and control groups based on the classification of the location of most prominent point of septal deviation.</p><p><strong>Conclusion: </strong>In the present study, we were unable to establish a definitive causality between deviated nasal septum and the occurrence of an Antrochoanal polyp. However, deviation of the nasal septum between the anterior and posterior ends of the middle turbinate may act as a contributory factor in the formation of ACP.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 2","pages":"93-98"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Orbit: Endoscopic Transnasal Transorbital Approach to Orbital Cavernous Hemangiomas.","authors":"Vineeth Viswam, Sreelakshmi Muraleedharan, Shyam Sundar Sreedhar, Amala Salil","doi":"10.22038/ijorl.2026.92167.4066","DOIUrl":"https://doi.org/10.22038/ijorl.2026.92167.4066","url":null,"abstract":"<p><strong>Introduction: </strong>Orbital cavernous hemangiomas are common benign orbital tumors often presenting with slowly progressive proptosis, visual disturbances, or diplopia. Although histologically the lesion is benign in nature, its features, such as a progressive increase in tumor size, result in optic nerve compression necessitating surgical removal. Traditional external approaches such as lateral orbitotomy or transcranial surgery are the most commonly employed approaches, but they are associated with higher morbidity, significant tissue disruption and visible scarring. Evolution of Endoscopic Skull Base Surgical Techniques has helped surgeons in designing a cosmetically favourable minimally invasive route.</p><p><strong>Case report: </strong>Here we report a case of a 69-year-old male diagnosed with a right orbital cavernous hemangioma who underwent endoscopic transnasal transorbital approach and excision of lesion under neuronavigation guidance.</p><p><strong>Conclusion: </strong>This case report highlights the growing role of endoscopic transnasal approaches in the management of orbital lesions by providing direct access to medial and infero-medial orbital compartments.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 4","pages":"265-270"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Curcumin on Olfactory Dysfunction and Indoxyl Sulphate in Hemodialysis Patients.","authors":"Irnanda-Warda-Rizki Nasution, Tengku-Siti-Hajar Haryuna, Syafrizal Nasution, Delfitri Munir, Khalisanni Khalid","doi":"10.22038/ijorl.2026.88960.3990","DOIUrl":"https://doi.org/10.22038/ijorl.2026.88960.3990","url":null,"abstract":"<p><strong>Introduction: </strong>Neurological abnormalities in uremic conditions are indicated by olfactory impairment in the population with long-term renal disease, which escalates in prevalence with the degree of severity of renal disease. Indoxyl Sulphate is a kind of toxic substance that exacerbates kidney damage. Since it scavenges ROS or reactive oxygen species, curcumin helps prevent disease development and promotes olfactory ensheathing cell growth and viability under normal and hypoxic settings.</p><p><strong>Materials and methods: </strong>For 12 weeks, 48 patients with stage 5 chronic renal disease receiving regular haemodialysis were split into three groups: the control group, the 500 mg curcumin group, and the 1000 mg curcumin group. Plasma indoxyl Sulphate concentrations and subsequent olfactory function were assessed. The results were compared using bivariate and multivariate analysis.</p><p><strong>Results: </strong>The olfactory function delta (p=0.002) and discrimination of olfactory delta (p=0.001) of the 500 mg and 1000 mg curcumin groups differed significantly. The 500 mg curcumin group's IS levels (p=0.008) and the control group's (p=0.019) delta IS level (p=0.870) were significantly different from the 1000 mg curcumin olfactory group's olfactory identification (p=0.006) and delta identification (p=0.618). The olfactory thresholds of the three study groups did not differ significantly (p=0.636).</p><p><strong>Conclusion: </strong>Curcumin therapy alleviated olfactory impairment in individuals with chronic renal illness; no increase in indoxyl Sulphate levels was observed, suggesting that curcumin may stabilize the toxin.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 4","pages":"231-239"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Preliminary Evaluation of an Endoscopic Eustachian Tube Orifice Patency Score (ETOPS): A Pilot Study.","authors":"Regin William","doi":"10.22038/ijorl.2026.96623.4176","DOIUrl":"10.22038/ijorl.2026.96623.4176","url":null,"abstract":"<p><strong>Introduction: </strong>Eustachian tube dysfunction (ETD) is a common condition that can lead to middle ear disorders and significantly affect quality of life. This study aimed to develop a novel Endoscopic Eustachian Tube Orifice Patency Score (ETOPS) and explore its potential relationship with ETD.</p><p><strong>Materials and methods: </strong>In this prospective observational study, 40 adult patients presenting with symptoms suggestive of ETD underwent diagnostic nasal endoscopy using a 70° endoscope. The Eustachian tube nasopharyngeal orifice was graded using the newly proposed ETOPS. ETOPS values were compared with ETDQ-7 symptom scores and tympanometric findings.</p><p><strong>Results: </strong>A significant positive correlation was observed between ETOPS and ETDQ-7 scores (r = 0.74, p < 0.001). Inter-observer reliability was good (ICC = 0.89). Patients with Type B and Type C tympanograms demonstrated significantly higher ETOPS values than those with Type A tympanograms (p < 0.001).</p><p><strong>Conclusion: </strong>The proposed ETOPS may serve as a simple and reproducible endoscopic grading system for evaluating Eustachian tube dysfunction. Further validation using real patient data is required to establish its clinical utility.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 5","pages":"327-332"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Factors Associated with Post-Tonsillectomy Bleeding in Adults.","authors":"Masoud Janipour, Fatemeh Keshavarz, Amirhossein Babaei","doi":"10.22038/ijorl.2026.93656.4108","DOIUrl":"10.22038/ijorl.2026.93656.4108","url":null,"abstract":"<p><strong>Introduction: </strong>Post-tonsillectomy hemorrhage is one of the most common and potentially life-threatening complications of tonsillectomy in adults and may result in readmission or reoperation. Adults are known to have a higher bleeding risk compared with children due to increased inflammation, comorbid factors, and surgical complexity. Identification of factors associated with postoperative bleeding is essential for optimizing surgical technique, postoperative care, and patient counseling.</p><p><strong>Materials and methods: </strong>This retrospective case-control study included adult patients (≥18 years) who underwent bilateral tonsillectomy at two tertiary referral hospitals between March 2021 and March 2023. Patients who developed post-tonsillectomy hemorrhage were compared with a matched control group without bleeding. Demographic characteristics, surgical indications, operative variables, and surgeon-related factors were evaluated. Post-tonsillectomy hemorrhage was defined as any postoperative pharyngeal bleeding confirmed by an otolaryngologist.</p><p><strong>Results: </strong>Among 350 adult tonsillectomies, post-tonsillectomy hemorrhage occurred in 54 patients (15.4%), predominantly secondary bleeding. In multivariate analysis, halitosis (p<0.001), chronic recurrent tonsillitis (p=0.001), sleep disturbances (p=0.001), use of sutures during the primary procedure (p=0.002), and surgeon experience (p=0.013) were independently associated with post-tonsillectomy hemorrhage. Tonsillolith showed a borderline association (p=0.054), while body mass index was not significant (p=0.748). No significant differences were observed in age, sex, smoking status, tonsillar hypertrophy grade, or operative duration (p>0.05). Most bleeding episodes occurred spontaneously (59.3%), and bleeding resolved without surgical intervention in 66.7% of cases.</p><p><strong>Conclusion: </strong>Several patient- and surgery-related factors were associated with post-tonsillectomy hemorrhage in adults. Recognition of these associations may aid in perioperative risk assessment and postoperative management.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 3","pages":"189-196"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Maneuver: Impact of Structured Counselling on Functional Recovery in Benign Paroxysmal Positional Vertigo.","authors":"Shashank Nema, Ripu Daman Arora, Himanshi Grover","doi":"10.22038/ijorl.2026.92369.4075","DOIUrl":"10.22038/ijorl.2026.92369.4075","url":null,"abstract":"<p><strong>Introduction: </strong>This study assessed the effect of supplementing Canalith Repositioning Maneuvers (CRM) with structured counselling on functional recovery in patients with Benign Paroxysmal Positional Vertigo (BPPV).</p><p><strong>Materials and methods: </strong>In this prospective, controlled study, sixty patients with posterior or lateral canal BPPV underwent appropriate CRM. Patients were randomly allocated to receive either CRM alone or CRM combined with structured counselling. Functional recovery was assessed using the Dizziness Handicap Inventory (DHI) at baseline and one week after treatment. Handicap recovery was calculated as the change in DHI score (ΔDHI). Multivariate linear regression analysis was performed to determine whether counselling independently predicted handicap recovery after adjusting for age, sex, canal involvement, and baseline DHI severity.</p><p><strong>Results: </strong>Both groups showed significant DHI improvement after-CRM. However, the Intervention Group demonstrated a significantly greater mean ΔDHI (28.80 ± 3.13) compared to the Control Group (22.47 ± 4.66), with a mean difference of 6.33 point (p < 0.001). Furthermore, fewer patients in the Intervention Group (6.7% vs. 20%) returned to the clinic prematurely with concerns about persistent symptoms. After multivariate adjustment, structured counselling remained an independent predictor of greater handicap recovery (β = 5.07; 95% CI: 3.15-6.98; p < 0.001). Baseline DHI severity was also independently associated with recovery (p < 0.001), age, sex, and canal involvement were not significant predictors.</p><p><strong>Conclusion: </strong>Structured post-maneuver counselling independently enhances early functional recovery in patients with BPPV beyond the effect of CRM alone. Incorporating counselling into routine BPPV management may improve patient-perceived outcomes during the early recovery phase.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 2","pages":"109-115"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Neuroglial Heterotopia of Nasopharynx.","authors":"Yellur Kavitha, Upendra Kumar Joish","doi":"10.22038/ijorl.2025.88070.3960","DOIUrl":"10.22038/ijorl.2025.88070.3960","url":null,"abstract":"<p><strong>Introduction: </strong>Neuroglial heterotopia (NGH), is a displaced mass of mature central neuroepithelial tissue unconnected to the brain proper. NGH presents mostly with respiratory distress, neck mass and feeding difficulties at early age.</p><p><strong>Case report: </strong>In our case, the nasopharyngeal NGH, a nine years old female child presented with otalgia and reduced hearing of left ear. Otological examination showed secretory otitis media. On nasal endoscopy solitary, smooth, mucosa covered mass on the eustachian tube opening of left side blocking eustachian tube orifice. Imaging showed a well-defined, non-enhancing, isodense soft tissue lesion arising from left lateral wall of nasopharynx with complete opacification of middle ear and mastoid. Patient underwent left myringotomy and grommet insertion. Nasopharyngeal mass removed trans-nasally under endoscopic guidance. Histopathological examination of the mass showed features of Neuroglial heterotopia. Patient improved symptomatically.</p><p><strong>Conclusion: </strong>Possibility of NGH should be considered while evaluating children with congenital nasopharyngeal mass. Thorough clinical evaluation, radiological imaging to rule out intracranial connection and complete excision are necessary for successful management of such cases.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 1","pages":"67-71"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mantle Cell Lymphoma Mimicking Parotid Neoplasm: A Rare Case Report.","authors":"Tejaswi Gupta, Sanjeev Yadav, Ahmed Aseem Naseem, Sanjeev Kumar Singh, Rashmi Rashmi","doi":"10.22038/ijorl.2025.88661.3973","DOIUrl":"10.22038/ijorl.2025.88661.3973","url":null,"abstract":"<p><strong>Introduction: </strong>Mantle cell lymphoma (MCL) is a rare and aggressive B-cell non-Hodgkin lymphoma, commonly affecting lymph nodes, spleen, bone marrow, and gastrointestinal tract. Salivary gland involvement, especially in the parotid gland, is unusual and often mimics benign conditions, complicating diagnosis.</p><p><strong>Case report: </strong>A 58-year-old male presented with a painless, progressively enlarging swelling in the right preauricular region without facial nerve involvement. Imaging revealed a mass within the parotid gland, leading to superficial parotidectomy. Histopathology confirmed mantle cell lymphoma. Immunohistochemical studies showed positivity for CD20, BCL2, CD5, and Cyclin D1; negativity for CD23, CD10, BCL6, and MUM1; and scattered CD3-positive T lymphocytes. The Ki-67 proliferation index was approximately 40%, indicating intermediate proliferative activity. Whole-body PET-CT revealed additional metabolically active lesions suggestive of systemic disease. The patient was started on bendamustine and rituximab chemotherapy.</p><p><strong>Conclusion: </strong>This case highlights that parotid swellings may conceal systemic lymphomas, and misleading cytology can delay diagnosis. Clinicians should consider MCL in atypical parotid lesions to ensure early systemic therapy.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 1","pages":"61-65"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheal Nodular Fasciitis Presenting with Stridor: A Rare Case Report.","authors":"Manaswini Mallick, Debasmita Rath, Alok Das, Aparna Mohanty, Krishna Sai Sharan, Swagatika Samal","doi":"10.22038/ijorl.2025.85764.3885","DOIUrl":"10.22038/ijorl.2025.85764.3885","url":null,"abstract":"<p><strong>Introduction: </strong>Nodular fasciitis (NF) is a benign, rapidly growing, non-neoplastic myofibroblastic lesion of the subcutaneous tissue affecting various anatomical sites throughout the body. NF of the trachea is rare, and its occurrence in the pediatric age group is highly uncommon in clinical practice.</p><p><strong>Case report: </strong>2-year-old female child who presented to the emergency department with severe stridor causing critical airway obstruction. The mass was successfully excised via an emergent surgical procedure, and the definitive diagnosis of nodular fasciitis was established through histopathology examination, which revealed proliferation of spindle-shaped myofibroblasts in a myxoid stroma without features of malignancy.</p><p><strong>Conclusion: </strong>Early resuscitation is essential to save the patient's life, and histopathology confirms the diagnosis.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 1","pages":"55-59"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Subjective Symptom Severity and Radiologic Involvement in CRSwNP Patients Using SNOT-22 and Lund-Mackay Scores.","authors":"Sahar Fereydouni, Farahzad Jabbari-Azad, Maryam Khoshkhui, Yaser Yadegari, Mehdi Bakhshaee, Gohar Shahmirzadi, Hasan Mehrad Majd","doi":"10.22038/ijorl.2026.93267.4099","DOIUrl":"https://doi.org/10.22038/ijorl.2026.93267.4099","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory sinonasal disorder associated with persistent symptoms and considerable impairment in quality of life. While both subjective symptom scores and objective radiologic assessments are commonly used in clinical practice, the association between these two measures has not been fully established.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 141 patients with confirmed CRSwNP who were recruited from Qaem Hospital, Mashhad, Iran, during 2024-2025. Symptom burden was evaluated using the validated Persian version of the Sinonasal Outcome Test-22 (SNOT-22), whereas radiologic disease extent was assessed using the Lund-Mackay computed tomography scoring system. The relationship between SNOT-22 and CT scores was examined using Spearman's correlation analysis.</p><p><strong>Results: </strong>The mean SNOT-22 score was 51.00 ± 17.86, while the mean Lund-Mackay score was 17.71 ± 4.76. Analysis demonstrated a moderate positive correlation between SNOT-22 and CT scores (r = 0.347, p < 0.001). Patients with asthma or Samter's triad (n = 70) showed significantly higher SNOT-22 and Lund-Mackay scores compared with those without these comorbidities (p < 0.001).</p><p><strong>Conclusion: </strong>A moderate association was identified between symptom severity reported by patients and radiologic disease severity in CRSwNP. Coexisting asthma or Samter's triad was linked to a greater overall disease burden. These findings highlight the value of integrating subjective symptom scoring with objective radiologic assessment for more comprehensive evaluation and individualized management.</p>","PeriodicalId":14607,"journal":{"name":"Iranian Journal of Otorhinolaryngology","volume":"38 4","pages":"257-263"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}