{"title":"Effect of Intracochlear Brain-Derived Neurotrophic Factor on Guinea Pig Sensorineural Hearing Loss.","authors":"Deanna Gigliotti, Brian Blakley","doi":"10.1177/19160216251336679","DOIUrl":"10.1177/19160216251336679","url":null,"abstract":"<p><p>ImportanceThis study investigates the potential of brain-derived neurotrophic factor (BDNF) as treatment for sensorineural hearing loss (SNHL) in a guinea pig model to potentially advance hearing restoration strategies. The correlation between oxidation-reduction (REDOX) potential in blood and perilymph is evaluated to confirm using blood as a proxy for perilymph in further study.ObjectivesTo evaluate hearing following 2 intracochlear applications of BDNF as a therapy for hearing loss. To evaluate for correlation in REDOX potential of perilymph and auditory brainstem response (ABR).Study DesignPositive-control animal preclinical study.SettingTranslational laboratory science.ParticipantsAnimal model (guinea pigs).Intervention or ExposuresSNHL was created in 15 guinea pigs using intraperitoneal cisplatin (CDDP). SNHL was confirmed via ABR testing. Left ears received 2 intracochlear applications of BDNF in varying doses, 30 days apart. Right ears received saline as controls.Main Outcome MeasuresHearing threshold was determined using ABR testing. Animals underwent terminal surgery to measure the REDOX potential in cerebrospinal fluid (CSF) and blood. Analysis of variance for repeated measures using the SPSS v27 software was employed.ResultsVariable, subtotal hearing loss was established utilizing CDDP. Animal ABR thresholds after CDDP, prior to first BDNF application, were worse than baseline. There was no improvement in hearing thresholds when treated and nontreated ears were compared. Varying doses of BDNF did not produce differences in hearing thresholds. The REDOX potential of perilymph, blood, and CSF correlate in the same animal; however, the values themselves were significantly different.Conclusions and RelevanceThere is no improvement in guinea pig hearing with 2 intracochlear applications of BDNF when applied as described in this paper. Previous work suggested possible subclinical gain with 1 application; however, with 2 applications we found no improvement. The REDOX potential of blood and CSF correlates within an animal, suggesting blood may be used as a proxy for REDOX measures in perilymph.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251336679"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528385","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":"Randomized Comparison of Endoscopic Cartilage-Perichondrium Sandwich Technique Verses Underlay Technique for Large Tympanic Membrane Perforations.","authors":"Yajian Shen, Zhengcai Lou","doi":"10.1177/19160216251333748","DOIUrl":"https://doi.org/10.1177/19160216251333748","url":null,"abstract":"<p><p>ImportantTrimming perforation margins is the basic procedure for any myringoplasties; however, to date, little literature has been reported on the effect of no trimming perforation margins on sandwich graft tympanoplasty.ObjectiveThe objective of this study was to compare the graft success rate, hearing improvement, and complications of endoscopic cartilage-perichondrium Sandwich technique (CPST) and cartilage-perichondrium underlay technique (CPUT) for repairing chronic large perforations.Study DesignProspective randomized controlled trial.SettingTertiary referral center.Participants and InterventionOne hundred two patients with chronic large perforations with 50% to 75% of tympanic membrane (TM) were recruited and randomly allocated to CPST (n = 51) and CPUT (n = 51), raising tympanomeatal flap and trimming perforation margins were not performed in both techniques.Main Outcome MeasurersThe graft success rate, air-bone gap (ABG) gain, operation time, and postoperative complications were evaluated at 12 months.ResultsAll the patients complete 12 months follow-up. The mean operation time was 30.6 ± 3.7 minutes in the CPST group and 29.8 ± 6.1 minutes in the CPUT group (<i>P</i> = .751).The graft success rate was 92.2% in the CPST group and 96.1% in the CPUT group (<i>P</i> = .979). Endoscopic examination revealed the perichondrial flap gradually became scab in the CPST group, 70.6% patients had the absence of typical cone-shaped TM. However, no scab was seen on the surface of graft, and all the patients had cone-shaped TM in the CPUT group. The ABG gain wasn't significantly different (12.9 ± 3.3 dB vs 13.1 ± 1.7 dB, <i>P</i> = .689).The successful surgery was 94.1% in the CPST group and 96.1% in the CPUT group, the difference wasn't significant among the 2 groups (<i>P</i> = .932). In addition, no procedure-related complications and no graft cholesteatoma were found in both groups during the follow-up period.Conclusions and RelevanceThe operation time, 12 months graft success rate, hearing improvement were comparable between CPST and CPUT for repairing large perforation, although raising tympanomeatal flap and trimming the perforation margins were not performed in both techniques.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251333748"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970686","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}
Yixuan Song, Yudong Ning, Han Li, Yuqin He, Yang Liu, Shaoyan Liu
{"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}
Jennifer A Silver, Antonia Lagos-Villaseca, Gabriella Le Blanc, Jonathan Primiani, Raisa Chowdhury, Jonathan Young, Karen M Kost
{"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}
Kenny Do, Eric Kawana, Suparna Shah, Jonathan Salinas, Jo-Lawrence Bigcas
{"title":"Systematic Review: Effectiveness of Carbon Dioxide Lasers for Treatment of Adult Laryngeal Hemangioma.","authors":"Kenny Do, Eric Kawana, Suparna Shah, Jonathan Salinas, Jo-Lawrence Bigcas","doi":"10.1177/19160216251314789","DOIUrl":"10.1177/19160216251314789","url":null,"abstract":"<p><strong>Importance: </strong>Adult laryngeal hemangiomas are rare and may cause symptoms such as dysphonia, dysphagia, and dyspnea. Carbon dioxide (CO2) lasers offer an alternative approach to managing this rare condition.</p><p><strong>Objective: </strong>The objective of this study is to evaluate the effectiveness of CO2 lasers in treating adult hemangioma and to identify potential side effects associated with this treatment modality.</p><p><strong>Design/methods: </strong>The study utilizes the PRISMA model to systematically collect articles available in the current literature. The numbers obtained from each academic manuscript were then used to calculate the effectiveness of CO2 laser therapy in patients with laryngeal hemangiomas. Articles from 1949 to 2023 were gathered using the PRISMA systematic review method.</p><p><strong>Setting: </strong>Not applicable.</p><p><strong>Participants: </strong>Adult patients with laryngeal hemangioma who were treated with CO2 lasers.</p><p><strong>Intervention or exposures: </strong>Surgical management with CO2 lasers.</p><p><strong>Main outcome measures: </strong>Number of patients with at least a 50% reduction in laryngeal hemangioma size.</p><p><strong>Results: </strong>Two case reports, 4 case series, and 2 observational studies were included in this systematic review. For the case reports and series, only 1 out of the 19 patients experienced recurrence following CO2 laser treatment. However, some studies did not have adequate follow-up time. In the 2 observational studies, efficacy rates of 100% and 90.9% were reported by the authors respectively.</p><p><strong>Conclusion and relevance: </strong>Adult laryngeal hemangioma can be safely and successfully treated with CO2 laser microsurgery in well-selected cases. More studies, as well as longer patient follow-ups, are needed to truly assess the efficacy of CO2 laser in treating laryngeal hemangioma. This method provides a minimally invasive technique for adult patients with this rare disease.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251314789"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046754","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}
Elysia Grose, Silkan Bains, Yvonne Chan, Jessica Trac, Jennifer Anderson, John M Lee, Molly Zirkle, R Jun Lin
{"title":"Health Literacy in An Otolaryngology Patient Population.","authors":"Elysia Grose, Silkan Bains, Yvonne Chan, Jessica Trac, Jennifer Anderson, John M Lee, Molly Zirkle, R Jun Lin","doi":"10.1177/19160216251330630","DOIUrl":"10.1177/19160216251330630","url":null,"abstract":"<p><p>ObjectiveHealth literacy is defined as the ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health. This study aimed to assess the health literacy of patients seeking care at an adult tertiary care Otolaryngology-Head and Neck Surgery (OHNS) clinic and its correlation with sociodemographic information.Study DesignProspective cross-sectional study.SettingTertiary care OHNS clinic.ParticipantsNew adult patients who presented to a tertiary OHNS clinic from July 2022 to March 2023.InterventionsPatients were asked to complete a sociodemographic questionnaire and the BRIEF Health Literacy Screening Tool. The BRIEF is scored out of 20 with scores of 17 and higher showing adequate health literacy.Main Outcome MeasuresBivariate and multivariate analyses were performed to determine whether sociodemographic variables were associated with health literacy.ResultsTwo hundred eighteen patients were recruited (59% females, 32% were above age 65). Although the average score on the BRIEF was 17.0 ± 3.6, about 33% of participants were found to have inadequate health literacy. Non-native English speakers, racial minorities, immigrants, and those with a lower income were more likely to have poor health literacy.ConclusionThis study highlights that a significant number of patients presenting to a tertiary OHNS clinic have inadequate health literacy, with certain socioeconomic factors serving as predictors. Future research is needed to evaluate targeted interventions aimed at improving and advocating for health literacy among OHNS patients.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251330630"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340219","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}
Hugh Andrew Jinwook Kim, Daniel J Lee, Dongho Shin, Garret Horton, Monique Gignac, John M Lee, Yvonne Chan
{"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}
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
{"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}
Emeline Drapier, Edwin Regrain, Laurent Seidermann, Christian Van Nechel, Marc Labrousse, Jean-Charles Kleiber, Arnaud Bazin, Esteban Brenet, Xavier Dubernard
{"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 χ<sup>2</sup> 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}
Kylen Van Osch, Edward Madou, Sheena Belisle, Julie E Strychowsky
{"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 (CO<sub>2</sub>) 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 CO<sub>2</sub> 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 CO<sub>2</sub> 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 CO<sub>2</sub> 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}