Chinese journal of otorhinolaryngology head and neck surgery最新文献

{"title":"[Patterns of bilateral nasal airflow distribution and influencing factors in patients with obstructive sleep apnea].","authors":"Y H Shi, Y R Li, J H Liao, W Xu, D M Han","doi":"10.3760/cma.j.cn115330-20250110-00026","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20250110-00026","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the characteristics of the nasal cycle and the patterns of bilateral nasal airflow distribution in patients with obstructive sleep apnea (OSA). <b>Methods:</b> This cross-sectional study analyzed data from 29 healthy subjects (control group: 16 males, 13 females; age range 23-60 years, mean 31.03±8.67 years) and 41 patients with OSA (OSA group: 34 males, 7 females; age range 20-62 years, mean 39.73±11.27 years) who visited the Sleep Medicine Center of Beijing Tongren Hospital, Capital Medical University, between March 2022 and April 2025. Whole-night split-channel nasal airflow and polysomnography were performed to calculate nasal airflow laterality, nasal cycle duration, and the effects of severity, sleep stages, and body position on bilateral nasal airflow distribution during sleep were analyzed. <b>Results:</b> The nasal cycle duration in OSA patients was significantly shorter than in controls (179.5 min <i>vs</i>. 312.5 min, <i>χ²</i>=14.01, <i>P</i><0.001). Apnea-hypopnea index (AHI) and age were independent influencing factors. In the OSA group, the incidence of nasal cycle transitions within 10 minutes after wake [(observed)7/50 <i>vs.</i> 2/55(expected), <i>χ²</i>=14.32, <i>P</i><0.001], REM sleep [(observed)23/34 <i>vs.</i> 14/43(expected), <i>χ²</i>=8.14, <i>P</i>=0.004], and position changes (21/36 <i>vs.</i> 11/46, <i>χ²</i>=12.02, <i>P</i><0.001) was higher, while, in the control group, it was only associated with REM sleep (15/15 <i>vs.</i> 8/22, <i>χ²</i>=8.80, <i>P</i>=0.003). Nasal airflow lateralization in the OSA group showed a stronger correlation with body position. The nasal airflow lateralization in the supine position was significantly lower in OSA patients than in controls [REM stage: 0.626 (0.425, 0.743) <i>vs.</i> 0.781 (0.706, 0.857), <i>Z</i>=3.62, <i>P</i><0.001; N3 stage: 0.526 (0.438, 0.600) <i>vs</i>. 0.716 (0.608, 0.853), <i>Z</i>=2.17, <i>P</i>=0.032; N1/2 stage: 0.702 (0.526, 0.787) <i>vs</i>. 0.747 (0.663, 0.820), <i>Z</i>=1.68, <i>P</i>=0.095]. Multiple linear regression revealed that AHI explained 31.3% of the variance in nasal airflow lateralization during supine REM sleep. <b>Conclusions:</b> The nasal airflow regulation during sleep in OSA patients differs from that in healthy individuals. Compared with healthy subjects, OSA patients exhibit shorter nasal cycle durations, reduced nasal airflow lateralization in the supine position, and a higher likelihood of nasal cycle transitions triggered by position changes or arousal. Healthy subjects demonstrate high and stable nasal airflow asymmetry during sleep, with minimal influence from sleep stages or body position.</p>","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 ","pages":"1111-1118"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Efficacy analysis of different surgical approaches for anterior skull base malignant tumors involving the orbit].","authors":"C Wu, J Q Liu, L Wang, Y Qi, W Wei, Q H Zhang, Z L Wang","doi":"10.3760/cma.j.cn115330-20250331-00185","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20250331-00185","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the efficacy and safety of different surgical approaches for the treatment of anterior skull base malignancies involving the orbit. <b>Methods:</b> Retrospective analysis was conducted on patients with anterior skull base malignancies involving orbit who attended Xuanwu Hospital of Capital Medical University from April 2013 to July 2021. They were divided into endoscopic endonasal approach(EEA), lateral orbital approach(ELOA), and sublabial transmaxillary approach(ESTMA) groups according to the primary surgical approach. One-way analysis of variance and <i>χ²</i> test were used to compare the clinical characteristics, degree of tumour resection, rate of postoperative cranial nerve palsy and improvement of visual acuity; Log-rank test was applied to assess the difference in overall survival (OS). <b>Results:</b> One hundred and ninety-eight patients were enrolled, including 107 males and 91 females, aged (48.5±15.3) years. There were 153, 33, and 12 patients in the EEA, ESTMA, and ELOA groups, respectively. There were no significant differences among the three groups in age, gender, and history of radiotherapy, chemotherapy or surgery (<i>P</i>>0.05 for all). All patients in ELOA group had preoperative visual impairment (12/12), with a significantly higher percentage than EEA group (56/153) and ESTMA group (14/33) (<i>χ</i>²=19.72, <i>P</i><0.001). There was no significant difference between three groups in the degree of tumor resection (gross total resection: 84.97% <i>vs</i>. 81.82% <i>vs</i>. 58.33%, <i>χ</i>²=5.58, <i>P</i>>0.05), postoperative cranial nerve palsy rate (13.07% <i>vs</i>. 30.30% <i>vs</i>. 16.67%, <i>χ</i>²=5.95, <i>P</i>>0.05), visual improvement rate (58.93% <i>vs</i>. 57.14% <i>vs</i>. 58.33%, <i>χ</i>²=0.04, <i>P</i>>0.05) and 5-year OS (60.69% <i>vs</i>. 42.66% <i>vs</i>. 50.00%, <i>χ</i>²=3.22, <i>P</i>>0.05). <b>Conclusion:</b> All three surgical approaches were safe, effective and feasible treatment modalities.</p>","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 ","pages":"1078-1083"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of short-term efficacy and safety of transnasal endoscopic approach and the combined transconjunctival-endoscopic approach in resection of benign orbital apex lesions].","authors":"Q Zuo, Z D Zhang, J C Zhou, H L Jiang, Y Wang, Y H Zhang","doi":"10.3760/cma.j.cn115330-20250329-00173","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20250329-00173","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the early efficacy and safety of the exclusively transnasal endoscopic approach and the combined transconjunctival-endoscopic approach in the resection of benign orbital apex lesions. <b>Methods:</b> A retrospective analysis was conducted on 51 patients who underwent transnasal endoscopic resection of benign lesions in the orbital apex at Peking University Third Hospital from May 2021 to December 2024. The study population was composed of 17 males and 34 females, with the age of (39.4±12.4) years (range: 4 to 65 years). Pathology diagnoses were identified as orbital cavernous hemangioma (OCH, <i>n</i>=38), schwannoma (<i>n</i>=8), solitary fibrous tumor (<i>n</i>=1), mucocele (<i>n</i>=1), optic nerve sheath meningioma (<i>n</i>=1), pseudotumor (<i>n</i>=1), and organized hematoma (<i>n</i>=1). Two surgical approaches were compared as the exclusively transnasal endoscopic resection (<i>n</i>=27) and the combined transconjunctival-endoscopic approach (combined approach, <i>n</i>=24). Preoperative and postoperative evaluations were conducted for the best corrected visual acuity (BCVA), visual field, intraocular pressure (IOP), and exophthalmos before and after surgery. Demographic characteristics, tumor features, and postoperative complications were analyzed between the two surgical groups. Differences in Orbital Resection by Intranasal Technique (ORBIT) stage between the two surgical approaches were analyzed. SPSS 27.0 software was used for statistical analysis. <b>Results:</b> Among the 51 patients, 3 schwannomas underwent intracapsular resection (1 via exclusively transnasal endoscopic approach, and 2 via combined approach), and the remaining 48 patients underwent complete tumor resection. Significant postoperative improvements were observed in BCVA, visual field, IOP and exophthalmos (<i>t</i> value was 2.96, 4.34, 4.85, and 4.63, respectively, all <i>P</i><0.05). The combined approach required longer operative time but showed comparable intraoperative blood loss. Tumors resected via the combined approach were larger in volume, though not statistically significant. Postoperative complications (e.g., diplopia, mydriasis) were more frequent in the combined approach group but resolved within a short-term period. There was no significant difference in ORBIT stage between the two groups (<i>P</i>=0.178). <b>Conclusions:</b> Both exclusively transnasal and combined transconjunctival-endoscopic approaches prove safe and effective for benign orbital apex lesions resection. The combined approach ensures complete tumor removal.</p>","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 ","pages":"1070-1077"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical significance of continuous percutaneous CO₂ monitoring in severe OSA in children with NPPV].","authors":"Y Wei, J Zhang, Y Xu, Y J Liu, Y Li, Q C Duan","doi":"10.3760/cma.j.cn115330-20250110-00032","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20250110-00032","url":null,"abstract":"<p><p><b>Objective:</b> To explore the value and clinical significance of percutaneous CO₂ monitoring in non-invasive positive pressureventilator in the treatment of severe obstructive sleep apnea (OSA) in children. <b>Methods:</b> Retrospective analysis was conducted on 38 children with severe OSA, who were treated in Henan Children's Hospital from August 2023 to December 2024. All of the enrolled children were diagnosed by polysomnography(PSG), treated with non-invasive positive pressure ventilator (NPPV) according to the standard treatment plan, and continuously monitored with TcpCO₂. Arterial blood gas was analyzed before and after pressure titration and TcpCO₂ changes were compared between awake and sleep with arterial blood gas PaCO₂. The sleep parameters, parameters related to arterial blood gas, and the relationship between TcpCO₂ and alveolar hypoventilation in children were analyzed. The cut-off value of alveolar hypoventilation factors were estimated. Statistical analysis was performed using the SPSS 27.0 software. <b>Results:</b> (1)The difference between awake TcpCO₂ and sleep TcpCO₂ was statistically significant[(42.52±3.56)mmHg <i>vs</i>.(51.09±4.07)mmHg,<i>P</i><0.001), and the difference between sleep TcpCO₂ and morning PaCO₂ was statistically significant[(51.09±4.07)mmHg <i>vs</i>. (40.83±5.34)mmHg,<i>P</i><0.001]. (2) There was no significant difference in related indicators among different gender children, but the difference in BMI values between preschool and school age children was significant[(18.03±4.96)kg/m² <i>vs</i>.(25.21±5.25)kg/m²,<i>t</i>=-4.08,<i>P</i><0.001]. (3) Obstructive apnea hypopnea index(OAHI), oxygen desaturation index (ODI), and TcpCO₂ were independent risk factors for alveolar hypopnea, but there was no correlation between BMI and whether alveolar hypoventilation.(4).OAHI, ODI, and TcpCO₂ were predictive of the presence of alveolar hypoventilation. When the OAHI exceeded 54.7events/h, ODI exceeded 72.1 events/h, and TcpCO₂ exceeded 56.5 mmHg, the children were more likely to have alveolar hypoventilation. <b>Conclusion:</b> Transcutaneous carbon dioxide, OAHI and ODI can effectively predict whether children have alveolar hypoventilation, which is helpful for clinical treatment.</p>","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 ","pages":"1141-1146"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Retrospective analysis of endoscopic surgery in 60 cases of sinonasal squamous cell carcinoma].","authors":"S Teng, B R Yan, Z N Xu, M Jin, S Liu, Y N Sun","doi":"10.3760/cma.j.cn115330-20250401-00193","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20250401-00193","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analyze the efficacy of endoscopic nasal surgery for sinonasal squamous cell carcinoma (SNSCC) with orbital invasion, the factors affecting the prognosis of patients, and the treatment strategies for preserving the eyeball. &lt;b&gt;Methods:&lt;/b&gt; This was a retrospective cohort study, including 60 cases of SNSCC with orbital invasion treated in the Department of Otolaryngology-Head and Neck Surgery, the Second Affiliated Hospital of Harbin Medical University from October 2009 to October 2019. The cohort comprised 39 males and 21 females, aged 33-72 years. Orbital invasion was graded: Grade Ⅰ (destruction of the orbital bone wall), Grade Ⅱ (involvement of the periorbita/orbital fascia, extraconal fat, or medial lacrimal sac), and Grade Ⅲ (involvement of extraocular muscles, eyeball, orbital apex, or optic nerve). All cases underwent multi-disciplinary treatment (MDT), including otolaryngology, ophthalmology and oncology radiotherapy departments, and endoscopic nasal surgery. Survival curves were calculated by Kaplan-Meier method, Log-rank test and Cox risk model were used for univariate and multivariate analysis, respectively. &lt;b&gt;Results:&lt;/b&gt; Primary tumor sites were maxillary sinus in 19 cases (31.7%, including 6 cases of pterygopalatine fossa), ethmoid sinus in 25 cases (41.7%, 5 cases with skull base bone involvement but not dura mater), nasal cavity in 11 cases (18.3%), frontal sinus in 3 cases (5.0%), and sphenoid sinus in 2 cases (3.3%). Clinical stages included stage Ⅲ in 53 (88.3%) and stage Ⅳ in 7 (11.7%). The surgical methods of orbital invasion cases were as follows: 18 cases (30.0%) of grade I underwent orbital bone wall resection with orbital fascia and orbital contents preserved; 36 cases (60.0%) in Grade Ⅱ were resected the involved orbital fascia, extra-cone fat and lacrimal sac and preserved the internal cone structure of extra-ocular muscle. Six cases (10.0%) were grade Ⅲ, of which 2 cases were subjected to selective extraocular muscle resection with preserving eyeballs, and 4 cases were subjected to orbital contents removal. The 3-year and 5-year overall survival (OS) rates of all patients were 76.7% and 63.3%, respectively, and the 5-year survival rate of the local recurrence-free group was significantly higher than that of the recurrence group (69.4% &lt;i&gt;vs&lt;/i&gt;. 36.4%, &lt;i&gt;χ&lt;/i&gt;²=3.91, &lt;i&gt;P&lt;/i&gt;=0.048). The 5-year survival rates were significantly negatively correlated with the degrees of orbital invasions (83.3% for grade Ⅰ, 58.3% for grade Ⅱ and 33.3% for grade Ⅲ, (&lt;i&gt;χ&lt;/i&gt;²=10.49, &lt;i&gt;P&lt;/i&gt;=0.005). The effects of T stages (66.7% in stage T3 &lt;i&gt;vs&lt;/i&gt;. 33.3% in stage T4, &lt;i&gt;χ&lt;/i&gt;²=7.21, &lt;i&gt;P&lt;/i&gt;=0.007) and clinical stages (67.9% in stage III &lt;i&gt;vs&lt;/i&gt;. 28.6% in stage IV, &lt;i&gt;χ&lt;/i&gt;²=11.80, &lt;i&gt;P&lt;/i&gt;=0.001) on survival rates were statistically significant. The 5-year survival rate of patients with cervical lymph node metastases was significantly lower than that of patients without metastasis (37.5% &lt;i&gt;vs&lt;/i&gt;. 67.","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 ","pages":"1084-1089"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Characteristics analysis of OSA patients in different age groups based on 10 years of PSG monitoring].","authors":"L L Peng, J R Li, Z Liu, C Zhang, S Z Zou, W Yuan, L L Yu, Y Y Jia","doi":"10.3760/cma.j.cn115330-20250109-00022","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20250109-00022","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; A retrospective analysis was conducted on the clinical characteristics and polysomnography (PSG) features of patients with obstructive sleep apnea (OSA) of different ages. &lt;b&gt;Methods:&lt;/b&gt; From January 2015 to March 2024, the patients who underwent overnight PSG monitoring at the Sleep Respiratory Disease Diagnosis and Treatment Center, Department of Otolaryngology, Head and Neck Surgery, Sixth Medical Center of the PLA General Hospital were sequentially enrolled.A total of 4 396 patients[aged from 18 to 97(46.04±12.60)years] with OSA who met the criteria were finally enrolled and divided into the youth group (18-44 years old, &lt;i&gt;n&lt;/i&gt;=2 099), middle-aged group (45-59 years old, &lt;i&gt;n&lt;/i&gt;=1 641), and elderly group (≥60 years old, &lt;i&gt;n&lt;/i&gt;=656).The differences in general condition, Epworth sleepiness Scale (ESS) score, rapid eye movement sleep (REM) sleep time in total sleep time, micro-awakening index, apnea hypopnea index (AHI), minimum oxygen saturation at night (LSpO&lt;sub&gt;2&lt;/sub&gt;), oxygen hypoxia index (ODI) and so on were compared.Multivariate Logistic regression was used to analyze the relationship between age stratification and different severity of OSA (mild 5≤AHI≤15, moderate 15&lt;AHI≤30, severe AHI&gt;30, Times per hour). &lt;b&gt;Results:&lt;/b&gt; The neck circumference [(39.11±3.71) cm], body mass index [BMI, (26.63±3.70) kg/m²], total sleep time [(386.13±66.09) min], the percentage of deep sleep in total sleep time [(3.05±4.80)%], the percentage of REM sleep time in total sleep time [(16.73±6.83)%], apnea-hypopnea index [AHI, (31.17±19.20) events/h], oxygen desaturation index [ODI, (46.57±33.54) events/h], microarousal index [(14.82±12.27) events/h], and Epworth Sleepiness Scale (ESS) score (8.29±5.92) in the elderly group were all lower than those in the young group [neck circumference (41.36±3.37) cm, BMI (28.55±4.21) kg/m², total sleep time [(424.67±62.21) min], the percentage of deep sleep in total sleep time (5.89±6.79)%, the percentage of REM sleep time in total sleep time (17.95±6.67)%, AHI (39.55±27.89) events/h, ODI (61.88±34.60) events/h, microarousal index (22.77±19.31) events/h, ESS score (9.63±5.82)] and the middle-aged group [neck circumference (40.75±3.59) cm, BMI (27.89±3.55)kg/m², total sleep time [(410.98±63.02)min], the percentage of deep sleep in total sleep time (3.59±5.11)%, the percentage of REM sleep time in total sleep time (17.47±6.63)%, AHI (36.01±23.63) events/h, ODI (57.20±34.75) events/h, microarousal index (19.23±15.59) events/h, ESS score (9.98±6.11)], with &lt;i&gt;F&lt;/i&gt; values of 102.62, 62.15, 95.87, 95.94, 8.71, 29.60, 49.72, 59.11, and 19.03, respectively, and all &lt;i&gt;P&lt;/i&gt; values were &lt;0.001. The proportion of females [29.57% (94/656)], the proportion of patients with hypertension [37.20% (244/656)], and the nocturnal LSpO&lt;sub&gt;2&lt;/sub&gt; [(79.09±9.88)%] in the elderly group were all higher than those in the young group [proportion of females [6.48% (136/2 099)], proportion of patients with hypertension","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 ","pages":"1127-1133"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of imaging features of upper airway in obstructive sleep apnea patients with epiglottic collapse].","authors":"Y Zhang, Z Y Wei, X Y Ou, Y X Wang, Z H Lin, D Zhao","doi":"10.3760/cma.j.cn115330-20250104-00008","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20250104-00008","url":null,"abstract":"<p><p><b>Objective:</b> To analyze and summarize the characteristics and rules of upper airway computerized tomography (CT) in obstructive sleep apnea (OSA) patients with epiglottic collapse. <b>Methods:</b> As a cross-sectional study, OSA patients (all were male, aged 18 to 60) who received Han-uvulopalatopharyngoplasty (H-UPPP) surgery at Second Affiliated Hospital of Zhejiang University School of Medicine from April 2023 to February 2024 were continuously selected. All patients underwent physical examination, polysomnography (PSG) and three-dimensional CT plain scan of upper airway before surgery. Preoperative drug-induced sleep endoscopy (DISE) was performed on the day of surgery. According to the findings of DISE, all patients were divided into two groups: epiglottic collapse group and non-epiglottic collapse group. The relevant data were collected, and the measured data included epiglottic length, epiglottic width, epiglottic curvature, epiglottic angle, distance between epiglottis and posterior pharyngeal wall, distance between epiglottis and tongue base, angle between epiglottis and tongue base, the lymph tissue classification of the tongue base, airway length, mandibular - hyoid bone distance, soft palate length and soft palate - hard palate Angle. Statistical analysis was performed using SPSS 25.0. <b>Results:</b> There were a total of 104 patients with OSA, consisting of 27 patients with epiglottic collapse and 77 patients with non-epiglottic collapse. In this study, the incidence of epiglottic collapse was 25.96%. There were no significant differences in apnea hyponea index (AHI), minimum blood oxygen saturation and the time ratio of blood oxygen saturation below 90% (TS90) between the two groups (all <i>P</i>>0.05). Compared with the non-epiglottic collapse group, the epiglottic length [(19.77±2.42)mm <i>vs.</i> (18.54±2.62)mm,<i>t</i>=2.162,<i>P</i>=0.033] and the lymph tissue classification of the tongue base [4(1,4)<i>vs.</i>2(1,3),<i>Z</i>=-2.968,<i>P</i>=0.003] in the epiglottic collapse group increased. Distance between epiglottis and tongue base reduced [2.70(0,5.88) mm <i>vs.</i> 5.45(2.15,6.98)mm, <i>Z</i>=-2.385,<i>P</i>=0.017]. According to Logistic regression analysis, epiglottic collapse and epiglottic width (<i>OR</i>: 1.201; 95%<i>CI</i>: 1.009-1.430, <i>P</i>=0.039) were positively correlated, epiglottic curvature (<i>OR</i>: 0.979; 95%<i>CI</i>: 0.961-0.998, <i>P</i>=0.030) was negatively correlated, and with the grade of lymph tissue of tongue root (<i>OR</i>: 1.936; 95%<i>CI</i>: 1.294-2.896, <i>P</i>=0.001) was positively correlated. <b>Conclusion:</b> CT examination in awake OSA patients with epiglottic collapse can reveal its characteristic indicators. The wider the epiglottic width, the smaller the epiglottic curvature, and the larger the lymph tissue grade of the base of tongue were effective predictors of epiglottic collapse.</p>","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 ","pages":"1119-1126"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expert consensus on the treatment timing calender of congenital ear malformation with multiple malformations].","authors":"Y H Zou, H X Zhuang, S Q Zhao, Q H Yang, S J Chen, W Yuan, A C Deng, H Y Kang, E D Zhang, F Xue, M G Shu, J J Lu, W H Ye, G Q Zheng, G Y Qiao, X Qi, H X Zhou, M L Li, L L Wang, T Zhang, Y J Chen, L Li, L X Wang, R H Jiang, Y Q You, Y Lu","doi":"10.3760/cma.j.cn115330-20250205-00081","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20250205-00081","url":null,"abstract":"","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 ","pages":"1030-1039"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Transcriptomic expression profile characteristics of nasal polyps with uncontrolled disease after endoscopic sinus surgery].","authors":"K H Wang, L Xu, Y P Fan, J B Shi, Y Q Sun","doi":"10.3760/cma.j.cn115330-20240930-00553","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20240930-00553","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the transcriptomic signature of refractory nasal polyps (NP) after endoscopic sinus surgery. <b>Methods:</b> Tissue samples were collected from 36 patients with NP who underwent endoscopic sinus surgery at the Seventh Affiliated Hospital of Sun Yat-sen University and the First Affiliated Hospital of Sun Yat-sen University from January 2020 to December 2021. Raw sequencing data of normal nasal mucosa samples were downloaded from publicly available GEO database (Accession Number: GSE136825). Differential expression genes (DEGs) and Gene Ontology (GO) enrichment analysis were conducted to analyze the differences between refractory NP and normal controls, as well as among refractory, controlled, and partially controlled NP. Hierarchical clustering method was employed to analyze the inflammatory endotypes of NP. Weighted Gene Co-expression Network Analysis (WGCNA) and STRING database were used in combination with Cytoscape software to identify the characteristic transcriptional expression profiles of refractory NP. R software (version 4.3.1) was used for statistical analysis. <b>Results:</b> Refractory NP patients had significantly higher asthma comorbidity rates than controlled/partially controlled groups (<i>P</i><0.05). The numbers and percentages of peripheral blood and tissue eosinophilic granulocytes were significantly higher in the refractory subgroup than in the other two subgroups (<i>P</i><0.05). Compared to normal mucosa, controlled and partially controlled NP groups, 27 genes were consistently upregulated in refractory NP. Hierarchical cluster analysis showed that the refractory NP exhibited a mixed endotype dominated by type 2 inflammation with co-existing type 1 features. Differential genes were enriched in extracellular matrix organization, leukocyte activation, cytokine receptor activation, cystatin-mediated protease inhibition, granule exocytosis, and olfactory nerve development regulation. Further WGCNA analysis and protein-protein interaction network identified 33 hub genes represented by <i>ITGAM, NCF1, NCF2, CD1C, PTAFR, CLEC10A, SIRPA, TREM2, ALOX5AP, PTGDR2 (officially PTGDR), F13A1, DUOX2, NOS2, CTSG,</i> and <i>SALL1.</i> <b>Conclusion:</b> This study reveals the distinctive transcriptional signature of refractory NP through transcriptomic methods, providing novel research avenues and therapeutic targets for the treatment of refractory NP after surgery.</p>","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 8","pages":"928-936"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Study on the characteristics of laryngopharyngeal reflux events in patients with obstructive sleep apnea].","authors":"L L Liu, J R Li, Z Liu, C Zhang, L L Yu, Y Y Jia, R Zhang","doi":"10.3760/cma.j.cn115330-20250108-00017","DOIUrl":"https://doi.org/10.3760/cma.j.cn115330-20250108-00017","url":null,"abstract":"<p><p><b>Objective:</b> To study the characteristics of laryngopharyngeal reflux (LPR) events in patients with obstructive sleep apnea (OSA). <b>Methods:</b> This cross-sectional study analyzed OSA patients who were admitted in the Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of the Chinese PLA General Hospital between November 2020 to July 2023[OSA group, 52 males, 6 females, aged 23-69 (41.22±11.42) years], and non-OSA patients admitted during the same period serve as the control group[non-OSA group, 40 males, 1 female, aged 21-68 (45.12±11.30) years]. All participants completed the Reflux Symptom Index (RSI), Reflux Finding Score (RFS) scale, and 24-hour Hypopharyngeal Esophageal Multichannel Intraluminal Impedance-pH (HEMII-pH) monitoring. LPR events were categorized based on their physical composition-liquid, gas, or gas-liquid mixed, according to the change of impedance values; and further classified by pH levels as acidic, weakly acidic, or alkaline. Differences in LPR events physical properties and the time trends of LPR events between the two groups were compared. Group comparisons were performed using t-test or Mann-Whitney <i>U</i>-test. Analyses were conducted using Pearson, Spearman, or Kendall's tau-b correlation analysis. Categorical data were analyzed using chi-square test. <b>Results:</b> A total of 99 patients were enrolled, including 58 with OSA and 41 without OSA. Of these, 88.89% (88/99) met the diagnostic criteria for laryngopharyngeal reflux disease (LPRD). In LPRD patients, the median proportion of non gas reflux events and the number of alkaline reflux were significantly higher in the OSA with LPRD group than in the non OSA with LPRD group (70.00% <i>vs</i> 36.36%, 0 <i>vs</i> 0, <i>Z</i>-values respectively -3.373, -3.134, <i>P</i><0.01). Liquid reflux proportion and the number of both liquid and mixed reflux events showed a positive correlation with the apnea-hypopnea index (AHI) (<i>r</i>-values respectively 0.304, 0.326, 0.268, <i>P</i><0.05), while the gas reflux constituent ratio was inversely correlated with AHI (<i>r</i>=-0.358, <i>P</i><0.01). The frequency and proportion of nocturnal reflux events showed a positive correlation with AHI (<i>r</i>-values respectively 0.250, 0.211, <i>P</i><0.05). A significantly higher proportion of OSA with LPRD group experienced both daytime and nighttime reflux compared to non OSA with LPRD group (66.67% <i>vs</i> 38.71%, <i>P</i><0.05). In LPRD patients, over 50% of all LPR events occurred within 3 hours after each of the three main meals. <b>Conclusions:</b> In OSA with LPRD patients, LPR events are predominantly non gas in nature. OSA with LPRD patients exhibits a higher proportion and frequency of nocturnal reflux events and a greater number of alkaline reflux episodes compared to non OSA with LPRD patients.</p>","PeriodicalId":23987,"journal":{"name":"Chinese journal of otorhinolaryngology head and neck surgery","volume":"60 8","pages":"875-881"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}