Journal of Otolaryngology - Head & Neck Surgery最新文献

{"title":"Nomogram Predicting Progression-Free Survival in Locally Advanced Papillary Thyroid Cancer with Recurrent Laryngeal Nerve Invasion.","authors":"Yixuan Song, Yudong Ning, Han Li, Yuqin He, Yang Liu, Shaoyan Liu","doi":"10.1177/19160216251314750","DOIUrl":"10.1177/19160216251314750","url":null,"abstract":"<p><strong>Objectives: </strong>The recurrence rate of T4a papillary thyroid cancer (PTC) is relatively high, but research on the prognosis of T4a PTC is rarely investigated. This study aims to analyze the prognosis of T4a PTC patients with recurrent laryngeal nerve (RLN) invasion.</p><p><strong>Methods: </strong>Univariable and multivariable Cox proportional hazard models were employed to identify prognostic factors for the progression-free-survival (PFS) of PTC patients. A nomogram was constructed based on essential prognostic factors to predict the risk of disease progression in T4a PTC patients with RLN invasion.</p><p><strong>Results: </strong>A total of 418/602 (69.4%) T4a PTC patients with RLN invasion underwent surgery, the 5-year PFS rate was 89.8%. The multivariable analyses showed that age ≥55 years, preoperative vocal cord paralysis (VCP), microvascular invasion, and the number of cervical lymph node metastases (CLNM) >10 were prognostic risk factors of PFS in T4a PTC patients with RLN invasion. Our nomogram provided good discrimination, with a C-index of 0.778 in the training set and 0.793 in the validation set. No statistical difference (<i>P</i> = .918) was found between PFS and the surgical methods of RLN. By following up on the patient's voice condition, the RLN function was restored in approximately 82.7% of patients after RLN separation.</p><p><strong>Conclusion: </strong>T4a PTC patients with RLN invasion are prone to disease progression under the following conditions: age ≥55 years old, preoperative VCP, microvascular invasion, and CLNM >10. The RLN nerve preservation surgery does not increase the risk of disease progression.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251314750"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408867","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":"Validation of the Reflux Symptom Index in French-Speaking Quebec Patients.","authors":"Jennifer A Silver, Antonia Lagos-Villaseca, Gabriella Le Blanc, Jonathan Primiani, Raisa Chowdhury, Jonathan Young, Karen M Kost","doi":"10.1177/19160216251333357","DOIUrl":"https://doi.org/10.1177/19160216251333357","url":null,"abstract":"<p><p>ImportanceThere is a need to culturally adapt this commonly used patient-reported outcome measure, the Reflux Symptom Index (RSI), for use in Canada and Quebec's French population.ObjectiveTo translate and validate the RSI for use in Quebec French speakers, ensuring reliability and validity within this population.DesignProspective case-control study.SettingVoice and Dysphagia Laboratory at the McGill University Health Centre in Montreal, Quebec, Canada.ParticipantsPatients with laryngopharyngeal reflux (LPR) and healthy controls were recruited during outpatient clinical laryngology visits. Participants were eligible if they were at least 18 years old and spoke French as their native language.Intervention or ExposuresA Quebec-French version of the RSI (Q-Fr-RSI) was validated using the \"translation-back-translation\" method. Participants completed the Q-Fr-RSI, Fr-VHI, and their laryngoscopy was examined and assigned a Reflux Finding Score at their initial visit. Participants repeated the Q-Fr-RSI via telephone follow-up.Main Outcome MeasuresFeasibility, internal consistency, test-retest reliability, and construct validity of the Q-Fr-RSI were assessed.ResultsEighty-nine participants were recruited: 49 patients within the experimental group and 40 subjects within the control group. The feasibility was evaluated as percentage of missing answers in the full sample at the first time point, 0%, and second time point, 1.2%. Internal consistency via Cronbach's alpha was high (.90). Intra-rater reliability via intraclass correlation demonstrated good level of agreement (.84). Internal validity demonstrated a strongly significant difference between the groups' answers (mean score of 23.9 vs 6.65, respectively, <i>P</i> < .001).ConclusionsThis data suggest that the Q-Fr-RSI can be used to assess LPR in the French-speaking Canadian population.RelevanceIn the bilingual country of Canada, and especially in the province of Quebec where over 90% of people speak French, an appropriate validation of the Q-Fr-RSI allows all patients to be monitored adequately. A Quebec-French patient-reported outcome measure can accurately represent these patients in future research studies utilizing these metrics.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251333357"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064088","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":"Assessing the Use of Patient-Reported Outcome Measures in the Routine Clinical Care of Chronic Rhinosinusitis Patients: A Canadian Perspective.","authors":"Hugh Andrew Jinwook Kim, Daniel J Lee, Dongho Shin, Garret Horton, Monique Gignac, John M Lee, Yvonne Chan","doi":"10.1177/19160216241288806","DOIUrl":"https://doi.org/10.1177/19160216241288806","url":null,"abstract":"<p><strong>Importance: </strong>Chronic rhinosinusitis (CRS) is a common inflammatory disease of the paranasal sinuses with significant quality of life impairments. There is a need to implement outcome-based metrics to evaluate the outcomes of CRS treatment with endoscopic sinus surgery or biologics.</p><p><strong>Objective: </strong>We aimed to understand Canadian otolaryngologists' opinions on patient-related outcome measures (PROM) for CRS and identify potential barriers to implementation.</p><p><strong>Design: </strong>Qualitative research.</p><p><strong>Setting and participants: </strong>A cross-sectional survey was distributed via the Canadian Society of Otolaryngology-Head and Neck Surgery and direct emailing.</p><p><strong>Measures: </strong>Participants' demographics, practice information, and opinions on PROM were collected.</p><p><strong>Results: </strong>Of 346 (23%) Canadian otolaryngologists, 78 responded to the survey (26 rhinology fellowship-trained, 51 non-fellowship-trained, and 1 missing data). Thirty-eight responded that they collect PROM (69% with fellowship-trained, 39% non-fellowship-trained, <i>P</i> = .029). Regarding opinions on PROM, 74% of respondents agreed that it helps patients report their symptoms, 42% agreed that it improves the efficiency of the patient encounter, 54% agreed that it is easy for patients to understand, 62% agreed that it improves management and monitoring of clinical outcomes, and 71% disagreed that PROM is not helpful. Fellowship-trained otolaryngologists were 4 times more likely to agree that PROM improves management and monitoring of clinical outcomes (<i>P</i> = .014), and no other differences in opinions were significant. The most-frequently-identified barriers to PROM usage were lack of time for 67% of respondents, difficulty integrating into clinical workflow for 64%, and lack of integration into the electronic medical record for 47%. If these barriers were addressed, 86% of respondents said they would use PROM in their practice.</p><p><strong>Conclusions and relevance: </strong>Despite the low uptake of PROM among otolaryngologists without rhinology fellowship, opinions were generally favorable. We identified barriers that, if addressed, may increase their use in clinical practice. As resource-limited therapies such as biologics become more prevalent in CRS management, PROM may find more applications in shared clinical decision making.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241288806"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468072","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":"Survival Analysis and Prognostic Factors After Endonasal Resection of Advanced Olfactory Neuroblastomas: A Single Institution Experience.","authors":"Xiaole Song, Jingyi Yang, Cuncun Yuan, Dantong Gu, Li Wang, Qianqian Zhang, Chengle Zhou, Huan Wang, Li Hu, Chen Zhang, Quan Liu, Dehui Wang, Xicai Sun, Hongmeng Yu","doi":"10.1177/19160216241267737","DOIUrl":"10.1177/19160216241267737","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the prognostic factors in patients with advanced olfactory neuroblastoma (ONB) underwent endoscopic surgery.</p><p><strong>Materials and methods: </strong>Retrospective medical records were reviewed of patients with pathologically proven ONB who underwent endoscopic surgical resection. Clinicopathological characteristics including patient demographics, treatment, complications, follow-up, and outcomes were analyzed. Kaplan-Meier overall survival (OS) and disease-free survival (DFS) curves were plotted. Univariate and multivariate Cox regression models were used to determine prognostic factors.</p><p><strong>Results: </strong>Eighty-five patients with Kadish stage C ONB were examined. According to the various staging systems used, most patients harbored modified Kadish stage C (78.8%). Twenty-six patients (30.6%) underwent bony skull base resection, 11 (12.9%) underwent dura resection, and 24 (28.2%) underwent additional intracranial resection that included the olfactory bulb and duct. Median follow-up was 39 months. Five-year OS and DFS rates were 83.7% and 74.9%, respectively. Five-year OS was 100% in patients treated with bony skull base resection and 77.5% in those who were not (<i>P</i> = .052). Dura resection did not improve OS. Multivariate Cox regression analysis identified perioperative complications (<i>P</i> = .009), gross total resection (<i>P</i> = .004), orbital invasion (<i>P</i> = .014), postoperative radiotherapy (<i>P</i> = .030), and bony skull base resection (<i>P</i> = .019) as independent prognostic predictors.</p><p><strong>Conclusion: </strong>For patients with advanced ONB, endoscopic surgery in conjunction with radiotherapy and chemotherapy is effective and safe. Dura resection should be performed with caution in selected patients to balance survival and complications. Postoperative radiotherapy is important to improve OS and DFS.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241267737"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11337177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008962","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":"Are Vestibuloocular Reflex Gain and Dynamic Visual Acuity Responsible of Oscillopsia After Complete Unilateral Vestibular Loss?","authors":"Emeline Drapier, Edwin Regrain, Laurent Seidermann, Christian Van Nechel, Marc Labrousse, Jean-Charles Kleiber, Arnaud Bazin, Esteban Brenet, Xavier Dubernard","doi":"10.1177/19160216241265091","DOIUrl":"10.1177/19160216241265091","url":null,"abstract":"<p><strong>Background: </strong>Acute and complete unilateral vestibular deafferentation induces a significant change in ipsilateral vestibuloocular reflex gain, making the patient unable to stabilize gaze during active or passive head movements. This inability creates the illusion that the visual environment is moving, resulting in persistent visual discomfort during rapid angular or linear acceleration of the head. This is known as oscillopsia. Our objective was to understand if the spontaneous sensation of oscillopsias after complete unilateral vestibular deafferentation by vestibular neurotomy at 5 days (D5) and at 3 months (M3) is correlated with the loss of vestibuloocular reflex gain and dynamic visual acuity.</p><p><strong>Methods: </strong>Retrospective cohort study was conducted in an otolaryngology tertiary care center (2019-2022) on patients with complete unilateral vestibular loss by vestibular neurotomy. They were divided into 2 groups according to the presence (group G1) or absence (group G2) of a spontaneous complaint of oscillopsia assessed at M3. Severity of oscillopsias evaluated by Oscillopsia Severity Questionnaire. Vestibuloocular reflex gain based on video head impulse test (vHIT) and the dynamic visual acuity were measured for each group at D5 and M3. Categorical variables were compared using χ² test and quantitative variables using the nonparametric Wilcoxon-Mann-Whitney test.</p><p><strong>Results: </strong>All patients have a complete vestibular deafferentation at D5 and M3. At D5 (G1 = 8 patients, G2 = 5 patients), there is no significant difference for ipsilateral and contralateral vestibuloocular reflex gains and dynamic visual acuity losses. The Oscillopsia Severity Questionnaire was 2.68 ± 1.03 in G1 and 1.23 ± 1.03 in G2 (<i>P</i> < .05). At M3 (G1 = 9 patients, G2 = 6 patients), there is no significant difference between groups for epidemiologic and clinical data and for vestibuloocular reflex and dynamic visual acuity losses. The Oscillopsia Severity Questionnaire was 2.10 ± 0.63 in G1 and 1.24 ± 0.28 in G2 (<i>P</i> < .05).</p><p><strong>Conclusions: </strong>The spontaneous disabling sensation of oscillopsia after complete unilateral vestibular loss is well assessed by the Oscillopsia Severity Questionnaire but cannot be explained by objective vestibular tests assessing vestibuloocular reflex gain (vHIT) or dynamic visual acuity loss at D5 or M3. Further studies are needed to measure the sensation of oscillopsia under real-life conditions and to identify the factors responsible for its persistence.</p><p><strong>Trial registration: </strong>Retrospectively registered.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241265091"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11307369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897589","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":"Reducing Unnecessary Instruments in Tonsil Hemorrhage Trays at a Canadian Tertiary Care Center: A Quality Improvement Project.","authors":"Kylen Van Osch, Edward Madou, Sheena Belisle, Julie E Strychowsky","doi":"10.1177/19160216241267719","DOIUrl":"10.1177/19160216241267719","url":null,"abstract":"<p><strong>Background: </strong>In the emergency department (ED), there are pre-assembled tonsillar hemorrhage trays for management of post-tonsillectomy hemorrhage and peritonsillar abscess. After use, the tray is sent to the medical device reprocessing (MDR) department for decontamination, sterilization, and re-organization, all at a significant cost to the hospital and environment.</p><p><strong>Objective: </strong>The goal of this project was to reduce unnecessary instruments on the tonsil hemorrhage tray by 30% by 1 year and report on the associated cost and carbon dioxide (CO₂) emissions savings.</p><p><strong>Methods: </strong>This quality improvement project was framed according to the Institute for Healthcare Improvement's Model for Improvement. ED and Otolaryngology-Head & Neck Surgery staff and residents were surveyed to determine which instruments on the tonsil hemorrhage trays were used regularly. Based on results, a new tray was developed and compared to the old tray using MDR data and existing CO₂ emissions calculations.</p><p><strong>Results: </strong>Tray optimization resulted in a total cost reduction from $1092.63 to $330.21 per tray per year, decreased processing time from 12 to 6-8 minutes per tray, and decreased CO₂ emissions from 6.11 to 2.85 kg per year for the old versus new tray, respectively. Overall, the new tray contains half the number of instruments, takes half the time to assemble, produces 50% less CO₂ emissions, and will save the hospital approximately $100,000 over 10 years.</p><p><strong>Conclusion: </strong>Healthcare costs and environmental sustainability are collective responsibilities. Surgical and procedure tray optimization is a simple, effective, and scalable form of eco-action.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241267719"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11307385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897591","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":"A Positive Parathyroid Washout May Obviate the Need for Nuclear Scintigraphy in Parathyroid Adenoma Localization: A Retrospective Study.","authors":"Alexander Moise, Mawaddah Abdulhaleem, Saruchi Bandargal, Sabrina Daniela da Silva, Richard J Payne, Veronique-Isabelle Forest","doi":"10.1177/19160216241304366","DOIUrl":"10.1177/19160216241304366","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive parathyroidectomy (MIP) in patients with a parathyroid adenoma (PA) requires imaging modalities for precise localization. Parathyroid hormone assay on ultrasound-guided fine-needle aspiration washout, or PTH washout, can be used for this purpose. It is unclear whether PTH washout complements traditional PA localization techniques such as a sestamibi (MIBI) scan or diminishes its need. This study aims to determine whether a positive PTH washout obviates the need for an MIBI scan in the preoperative localization of a PA.</p><p><strong>Method: </strong>A multi-center retrospective, comparative review comprised adult patients who underwent MIP at 2 McGill University teaching hospitals between 2018 and 2022. Patients who had both PTH washout and MIBI scan for preoperative localization of PA, final histopathology reports available, and preoperative/postoperative results recorded were included in the final analysis.</p><p><strong>Results: </strong>Of the 193 patients' charts reviewed, 87 were included in this study. Of these 87 patients, 74.7% (65/87) had a positive PTH washout result. Among those, MIBI correctly detected 90.8% (59/65) of the PAs. The MIBI scan did not contribute meaningful information for any of the 65 patients who had positive PTH washout results.</p><p><strong>Conclusion: </strong>These findings strongly support the use of preoperative dedicated ultrasound as the initial standard procedure. When a PA candidate on ultrasound is found, a PTH washout should be performed. If positive, it could suffice as the sole localization method for MIP surgery. When a PA was identified on ultrasound and confirmed with PTH washout, the MIBI scan did not add more information. Benefits include fewer patient tests, less exposure to ionizing radiation, and reduced healthcare expenses.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241304366"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854161","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":"The Effect of Different Concentrations of Epinephrine in Otoendoscopic Surgery on Surgical Field Clarity: A Double-Blind, Randomized Study.","authors":"Wenying Shu, Tingting Jin, Jinya Shi, Jingjie Li, Zhaoyan Wang","doi":"10.1177/19160216241288811","DOIUrl":"10.1177/19160216241288811","url":null,"abstract":"<p><strong>Importance: </strong>At present, there is no consensus on the concentration of epinephrine/physiological saline for subcutaneous injection into external auditory canal (EAC) under general anesthesia in otoendoscopic surgery. A randomized controlled trial (RCT) research is needed to provide reference, as this concentration can provide satisfactory surgical field clarity while maintaining patients' hemodynamic stability.</p><p><strong>Objective: </strong>Comparison of the effect of subcutaneous injection of different concentrations of epinephrine/physiological saline into EAC under general anesthesia in otoendoscopic surgery on surgical field clarity and hemodynamics.</p><p><strong>Design: </strong>This double-blind, RCT study was about the effect of topical epinephrine injection in otoendoscopic surgery.</p><p><strong>Setting: </strong>This study was conducted at a single institution.</p><p><strong>Participants: </strong>This study included 168 patients conformed to the inclusion criteria.</p><p><strong>Intervention: </strong>Patients were randomized to receive different concentrations of epinephrine/physiological saline injection (1:5000, 1:10,000, 1:20,000, or 1:40,000) into the junction of bone and cartilage at posterior wall of EAC during surgery.</p><p><strong>Main outcome measures: </strong>Surgical field clarity was assessed with surgical field clarity grading scale and tympanic membrane flap flipping time. Hemodynamic changes were monitored by clinical parameters of blood pressure, heart rate, and ST segment of ECG.</p><p><strong>Results: </strong>There were no statistically-significant differences in surgical field clarity grade (<i>P</i> = .577) and tympanic membrane flap flipping time (<i>P</i> = .490) among 4 concentration groups. Epinephrine injection did cause an increase in hemodynamic parameters when compared with baseline (<i>P</i> < .05). Compared with the relatively-lower concentration groups (1:20,000 and 1:40,000), the relatively-higher concentration groups (1:5000 and 1:10,000) had more significant and long-lasting effect until 30 minutes after injection.</p><p><strong>Conclusions and relevance: </strong>Four concentration groups of topical epinephrine injection in otoendoscopic surgery have the same effect on surgical field clarity. For the stability of patients' hemodynamics, we would prefer to recommend the use of concentrations with minimal impact on hemodynamics, ranging from 1:20,000 to 1:40,000.</p><p><strong>Trial registration: </strong>Clinical Trial Registry-China: ChiCTRI1800016647.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241288811"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468090","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":"The Impact of Middle Ear Packing Material Containing Antibiotic Ointment on Postoperative Infection After Myringoplasty.","authors":"Zhengcai Lou, Zihan Lou, Zhengnong Chen","doi":"10.1177/19160216241291810","DOIUrl":"https://doi.org/10.1177/19160216241291810","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to compare the postoperative infection and graft success rates, and the hearing improvement, after endoscopic cartilage underlay myringoplasty with versus without antibiotic ointment coating.</p><p><strong>Materials and methods: </strong>This was a retrospective case-control study. The clinical records of patients who underwent endoscopic cartilage underlay myringoplasty and who met the selection criteria were retrieved and divided based on middle ear packing status into groups with antibiotic ointment packing (AOP group) and with no antibiotic ointment packing (no-AOP group). The operation time, postoperative infection, graft success status, and hearing improvement were compared between the 2 groups.</p><p><strong>Results: </strong>Patients with 166 perforations constituted the AOP group, and patients with 141 perforations comprised the no-AOP group. At 3 months postoperatively, middle ear infections had occurred in 24 (14.5%) ears in the AOP group and 4 (2.8%) ears in the no-AOP group (<i>P</i> < .01). At 12 months postoperatively, the graft success rate was 81.3% in the AOP group and 97.9% in the no-AOP group (<i>P</i> < .01). No significant group differences were observed, preoperatively (<i>P</i> = .657) or postoperatively (<i>P</i> = .578), in the air-bone gap (ABG) values or mean ABG gains (<i>P</i> = .758).</p><p><strong>Conclusion: </strong>Middle ear packing without antibiotic ointment coating does not increase the postoperative infection rate or reduce the graft success rate after endoscopic cartilage underlay myringoplasty compared to antibiotic ointment coating. On the contrary, coating with antibiotic ointment increases the risk of postoperative infection given the complexity of middle ear manipulation.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241291810"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468091","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":"Most Common Pathogens Causing Rhinosinusitis in Patients Who Underwent Endoscopic Sinus Surgery Before, During, and After the COVID-19 Pandemic.","authors":"Hamad Almhanedi, Ahmad Aldajani, Emily Steinberg, Marc Tewfik","doi":"10.1177/19160216241291808","DOIUrl":"10.1177/19160216241291808","url":null,"abstract":"<p><strong>Importance: </strong>Chronic rhinosinusitis (CRS) significantly impacts patients' quality of life and incurs substantial healthcare costs. Understanding pathogen trends before, during, and after the COVID-19 pandemic can inform better management and treatment strategies.</p><p><strong>Objective: </strong>To identify the common pathogens associated with CRS and compare them across pre-pandemic, during-pandemic, and post-pandemic periods.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>McGill University Health Centre, Montreal, Canada.</p><p><strong>Participants: </strong>Around 147 patients were 18 years and older, diagnosed with CRS, underwent endoscopic sinus surgery within the specified timeframe (January 2017 to September 2023), and whose charts contained relevant microbiology information. Patients were categorized into 3 groups based on surgery dates: pre- (January 2018 to November 2019), during- (January 2020 to December 2021), and post-pandemic (February 2022 to September 2023).</p><p><strong>Main outcome measures: </strong>Distribution and prevalence of pathogens associated with CRS across the 3 time periods. Microbiology results from nasal cultures were analyzed to identify predominant pathogens.</p><p><strong>Results: </strong>Among the 147 patients, 46 distinct organisms were identified. <i>Staphylococcus aureus</i> was the most prevalent pathogen, increasing during the COVID-19 period (24.7%) compared to pre-pandemic (17.9%) and post-pandemic (21.5%) periods. Significant increases during the COVID-19 period were noted for <i>Aspergillus fumigatus</i> (6.8%, <i>P</i> < .001), <i>Enterobacter cloacae</i> (6.8%, <i>P</i> = .01), and <i>Cutibacterium acnes</i> (6.8%, <i>P</i> = .03). Post-pandemic, significant rises were observed in <i>Serratia marcescens</i> (<i>P</i> < .001) and <i>Achromobacter denitrificans</i> (<i>P</i> = .03).</p><p><strong>Conclusions and relevance: </strong>Significant shifts in CRS-associated pathogens occurred during the COVID-19 pandemic. Notable changes in the prevalence of <i>S. aureus</i>, <i>A. fumigatus</i>, <i>E. cloacae</i>, and <i>C. acnes</i> were observed during the pandemic, with increases in <i>S. marcescens</i> and <i>A. denitrificans</i> post-pandemic. These findings suggest that the pandemic's impact on healthcare practices and environmental factors influenced the microbial etiologies of CRS. Future research may explore the mechanisms driving these changes and their long-term implications for CRS management.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"53 ","pages":"19160216241291808"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546014","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}