Brazilian Journal of Otorhinolaryngology最新文献

{"title":"Efficacy and safety of corticosteroids in the management of chronic rhinosinusitis: A systematic review and meta-analysis of randomized and non-randomized studies","authors":"BinBin Wang,&nbsp;Feng Liu,&nbsp;Bo Wei","doi":"10.1016/j.bjorl.2026.101760","DOIUrl":"10.1016/j.bjorl.2026.101760","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of corticosteroids in Chronic Rhinosinusitis (CRS), focusing on health-related quality of life, disease severity, systemic steroid-sparing effects, and Serious Adverse Events (SAEs).</div></div><div><h3>Methods</h3><div>Following PRISMA 2020 guidelines, PubMed, Web of Science, and Cochrane CENTRAL were systematically searched for randomized and non-randomized studies in adults with CRS. Outcomes included SNOT-22 scores, endoscopic findings, systemic corticosteroid use, and SAEs. Risk of bias was assessed using RoB 2.0 and Newcastle-Ottawa Scale. Meta-analyses employed random-effects models, with pooled estimates reported as Mean Differences (MD) or Odds Ratios (OR) and 95% Confidence Intervals (95% CI).</div></div><div><h3>Results</h3><div>Eleven studies (3,542 patients) were included. Corticosteroid therapy significantly improved SNOT-22 scores (MD = −16.00, 95% CI: −18.91 to −13.09, <em>p</em> &lt; 0.0001; I² = 90.3%) and endoscopic outcomes (MD = −2.32, 95% CI: −2.71 to −1.94, <em>p</em> &lt; 0.001; I² = 61.2%). Local corticosteroids reduced systemic steroid dependence (OR = 0.30, 95% CI: 0.27–0.34, <em>p</em> &lt; 0.0001; I² = 0%). No statistically significant increase in SAEs was observed (OR = 1.47, 95% CI: 0.44–4.93, <em>p</em> = 0.9848; I² = 0%). Heterogeneity was high for SNOT-22 and endoscopic outcomes, but funnel plots showed no major publication bias.</div></div><div><h3>Conclusion</h3><div>Corticosteroids improve quality of life and objective disease measures in CRS while reducing reliance on systemic steroids, with no significant increase in SAEs. Future studies should compare delivery modalities, assess long-term safety, and explore biomarker-guided strategies.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 2","pages":"Article 101760"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An affordable and optimized 3D biomodel for sinonasal surgery training","authors":"Marcelo Augusto Antonio ,&nbsp;Sergio Lopes Fernandes Ramos ,&nbsp;Fernando Augusto Lima Marson ,&nbsp;Mariana Dalbo Contrera Toro ,&nbsp;Eulalia Sakano","doi":"10.1016/j.bjorl.2025.101750","DOIUrl":"10.1016/j.bjorl.2025.101750","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop and evaluate the anatomical accuracy and haptic fidelity of an affordable kit consisting of a silicone head, a foam support, and a 3D-printed biomodel of the paranasal sinuses for surgical training.</div></div><div><h3>Methods</h3><div>This single-center, technological, and interventional study detailed the development of a human sinus biomodel. Its anatomical and haptic evaluation was conducted by ten senior rhinologists, who performed 37 standard surgical tasks. Participants rated similarity to fresh cadaveric dissection on a 5-point Likert scale. Computed tomographic images were converted into a standard tessellation file through a combination of automatic and manual segmentation. This file was then used in a 3D printer to create the biomodel, which was customized with a red silicone coating to emulate mucosa, as well as silicone-insulated wire and acrylic yarn to simulate arteries and nerves. The model was mounted onto a silicone head and foam support, with a total production cost of US$ 43.37.</div></div><div><h3>Results</h3><div>The similarity of anatomic landmarks scored a mean above 4.0 ± SD on both sides. The lacrimal bone drilling/debulking procedure was somewhat suboptimal for exposing the lacrimal sac, scoring a mean of 3.1 ± 1.04 on the left side but 4.3 ± 0.64 on the right. Likewise, uncinectomy was rated 3.4 ± 1.02 on the left and 3.7 ± 0.90 on the right, while the periorbit incision received scores of 3.5 ± 0.92 on the left and 4.5 ± 0.50 on the right. All other steps received ratings above 4.0 ± SD.</div></div><div><h3>Conclusion</h3><div>This study presents a fully reproducible and cost-effective method for constructing a 3D sinus biomodel. The model demonstrated high anatomical and haptic fidelity, as validated by senior rhinologists, making it a valuable tool for surgical training in sinonasal procedures.</div></div><div><h3>Level of evidence</h3><div>This study provides Level 2 evidence.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 2","pages":"Article 101750"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined endoscopic and open frontolateral laryngectomy for glottic tumors involving the anterior commissure","authors":"Leonardo Haddad ,&nbsp;Fabio Pupo Ceccon ,&nbsp;Leticia Angélica da Silva Souza ,&nbsp;Beatrice Haase Ceccon ,&nbsp;João Vitor Pincelli ,&nbsp;Mateus Morais Aires","doi":"10.1016/j.bjorl.2025.101742","DOIUrl":"10.1016/j.bjorl.2025.101742","url":null,"abstract":"<div><h3>Objective</h3><div>The combined endoscopic and open frontolateral laryngectomy technique has been proposed to balance oncologic safety with functional preservation in the management of glottic tumors involving the Anterior Commissure (AC). This study aims to describe this technique in detail, its indications, and to present our institution’s case series.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted of all patients undergoing surgery for glottic lesions suspected of malignancy between 2017 and 2024 at a single institution. Patients treated with the combined endoscopic and open frontolateral laryngectomy approach were included. Surgical technique, indications, contraindications, and perioperative management were documented. Outcomes assessed included oncologic control, tracheostomy status, and laryngeal function.</div></div><div><h3>Results</h3><div>Among 138 patients treated surgically for suspected malignant glottic lesions, four patients underwent the combined approach. Tumor stages included T1b (n = 2), T2 (n = 1), and T3 (n = 1). All patients were male, with a mean age of 71.5-years. Local disease control was achieved in three patients (75%), while one T3 patient experienced recurrence requiring salvage radiotherapy, achieving subsequent disease control. All patients retained laryngeal function, with no need for permanent tracheostomy or reports of dysphagia. Postoperative dysphonia was characterized by roughness, breathiness, and high-pitched but functional voices.</div></div><div><h3>Conclusion</h3><div>The combined approach offers a feasible alternative for managing AC-involving glottic tumors, providing oncologic safety while preserving function. It enables precise tumor resection with limited sacrifice of normal tissue and the potential for phonation-preserving reconstruction. Given the small sample size, further studies are needed to validate its efficacy and long-term benefits.</div></div><div><h3>Level of evidence</h3><div>4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 2","pages":"Article 101742"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic diagnosis of macrotia in PIK3CA-Related Overgrowth Spectrum (PROS) and long-term outcome of otoplasty: a case report and literature review","authors":"Lili Chen ,&nbsp;Xuerui Hu ,&nbsp;Jingwen Li ,&nbsp;Chenlong Li ,&nbsp;Jing Ma ,&nbsp;Aijuan He ,&nbsp;Yaoyao Fu ,&nbsp;Tianyu Zhang","doi":"10.1016/j.bjorl.2026.101766","DOIUrl":"10.1016/j.bjorl.2026.101766","url":null,"abstract":"<div><h3>Objectives</h3><div>PIK3CA-Related Overgrowth Spectrum (PROS) is a highly heterogeneous disease. Facial Infiltrating Lipomatosis (FIL) is a rare PROS subset, and its atypical phenotypes, such as macrotia, present diagnostic and therapeutic challenges due to limited data. This study aims to detail the diagnostic and long-term management procedures for an extremely rare case of Macrotia associated with PROS/FIL.</div></div><div><h3>Methods</h3><div>To confirm the underlying etiology, Whole Exome Sequencing (WES) was performed, complementing routine clinical and pathological examinations. Otoplasty was used as the intervention to reduce ear size. Long-term follow-up was conducted to monitor surgical outcome, stability, and potential recurrence.</div></div><div><h3>Results</h3><div>WES identified a PIK3CA pathogenic variant (p.H1047R). Combined with pathological findings, the patient was definitively diagnosed with PROS manifesting as the FIL phenotype. The reductive otoplasty surgery achieved significant improvement in the affected ear's morphology, reducing the deformity to a minimal, aesthetically pleasing level. Crucially, the 1-year follow-up showed remarkable stability in the near-normal ear contour, without any signs of recurrence or overgrowth. The successful aesthetic restoration significantly alleviated the patient's psychological distress.</div></div><div><h3>Conclusions</h3><div>This case demonstrates that WES is essential for accurate molecular diagnosis of PROS/FIL in patients presenting with atypical phenotypes like Macrotia. Furthermore, otoplasty is an effective and reliable reconstructive strategy for restoring ear aesthetics in these patients, providing excellent and stable long-term results and improving patient quality of life.</div></div><div><h3>Level of evidence</h3><div>Level 4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 2","pages":"Article 101766"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetically predicted plasma metabolites mediate the relation between inflammatory factors and Meniere's disease","authors":"Jian Wang,&nbsp;Jian-Dao Hu,&nbsp;Jing Qian","doi":"10.1016/j.bjorl.2026.101772","DOIUrl":"10.1016/j.bjorl.2026.101772","url":null,"abstract":"<div><h3>Objective</h3><div>Emerging evidence suggests inflammation contributes to Meniere’s Disease (MD), a chronic vestibular disorder characterized by vertigo, hearing loss, and tinnitus. However, the causal role of Inflammatory Factors (IFs) and the mediating effects of Plasma Metabolites (PMs) in MD remain unclear. This study investigated bidirectional causality between IFs and MD and evaluated PMs as potential mediators.</div></div><div><h3>Methods</h3><div>Using Genome-Wide Association Study (GWAS) summary data, we performed bidirectional Mendelian Randomization (MR) analyses to assess causal links between 91 IFs, 1,400 PMs, and MD. Single Nucleotide Polymorphisms (SNPs) genome-wide significant for IFs, PMs, and MD served as instrumental variables. Inverse Variance Weighting (IVW), MR-Egger, and weighted median methods were applied. Mediation analysis quantified PMs’ role in IF-MD associations. Sensitivity analyses (MR-PRESSO, leave-one-out) tested robustness.</div></div><div><h3>Results</h3><div>Genetically predicted higher CCL23 levels reduced MD risk (IVW OR = 0.5757 per SD decrease; 95% CI 0.3679–0.9007; p = 0.0156). No reverse causality from MD to IFs was observed (IVW OR = 0.9919; 95% CI 0.9812–1.0028; p = 0.1448). Mediation analysis revealed PMs accounted for 14.6% of the protective effect of IFs on MD. Elevated IF levels correlated with increased PMs (IVW OR = 1.0788; 95% CI 1.0125–1.1494; p = 0.0192), while higher PMs reduced MD risk (IVW OR = 0.5444; 95% CI 0.3006–0.9859; p = 0.0448). Sensitivity analyses confirmed result consistency, with no significant pleiotropy.</div></div><div><h3>Conclusion</h3><div>This study identifies CCL23 as a protective factor against MD, partially mediated by PMs. Findings underscore inflammation and metabolic pathways as potential therapeutic targets. Further validation in diverse populations and exploration of biological mechanisms are needed to advance MD treatment strategies.</div></div><div><h3>Level of evidence</h3><div>5.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 2","pages":"Article 101772"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations of gut microbiome in chronic rhinosinusitis: insights from a mendelian randomization study","authors":"Ke-Shuang Wang ,&nbsp;Jun-Hao Tu ,&nbsp;Qian-Xing Wang ,&nbsp;Sui-Zi Zhou ,&nbsp;Jia-Rong Wu ,&nbsp;Qian-Hui Qiu","doi":"10.1016/j.bjorl.2025.101698","DOIUrl":"10.1016/j.bjorl.2025.101698","url":null,"abstract":"<div><h3>Objective</h3><div>Gut microbiome dysbiosis is associated with various diseases. Causal association between Chronic Rhinosinusitis (CRS) and gut microbiome is yet unknown. This study aimed to investigate the potential causal relationship between CRS and gut microbiome dysbiosis.</div></div><div><h3>Methods</h3><div>We used Genome-Wide Association Study (GWAS) data from FinnGen database for CRS. The Dutch Microbiome Project study provided data on gut microbiota species. A total of 334,182 individuals were included. Two-sample bidirectional Mendelian Randomization (MR) analysis was used to investigate causal relationship between CRS and gut microbiome. The main methods of evaluation were Inverse Variance Weighting (IVW), weighted median, weighted mode, and MR-Egger regression. Sensitivity analyses were performed to assess heterogeneity and pleiotropy.</div></div><div><h3>Results</h3><div>Forward MR analysis indicated CRS is potentially linked to decreased risk of <em>Haemophilus parainfluenzae</em> (OR = 0.79, 95% CI 0.66‒0.94, <em>p</em> = 0.009) and increased risk of Bilophila’s (OR = 1.14, 95% CI 1.02–1.27, <em>p</em> = 0.023) within the gut. Reduced risks in gut microbiota-related pathways like UDP<em>-N-</em>acetyl-<span>d</span>-glucosamine biosynthesis I (OR = 0.85, 95% CI 0.77‒0.94, <em>p</em> = 0.002) and increased risk in pathway NAD biosynthesis I from aspartate (OR = 1.14, 95% CI 1.03–1.27, <em>p</em> = 0.010) were also linked to CRS. Reverse MR analyses, we obtained no positive results (<em>p</em> &gt; 0.05/412).</div></div><div><h3>Conclusion</h3><div>This study reveals CRS exerts a causal impact on shifts within the composition of the gut microbiome and also links to the changes of gut microbiota-related metabolic pathways. The risk of changes in gut microbiota should be of greater concern in patients with CRS than in the general population.</div></div><div><h3>Level of evidence</h3><div>Mendelian Randomized (MR) studies are second only to randomized controlled trials in terms of the level of evidence.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101698"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145107491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence, emotional intelligence, and helplessness","authors":"Otavio B. Piltcher ,&nbsp;Claire Hopkins","doi":"10.1016/j.bjorl.2025.101745","DOIUrl":"10.1016/j.bjorl.2025.101745","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101745"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphocyte-to-monocyte ratio as a clinical predictor in sudden sensorineural hearing loss","authors":"Elvan Onan,&nbsp;Ozgur Surmelioglu,&nbsp;Caglar Eker,&nbsp;Muhammed Dagkiran,&nbsp;Ilda Tanrisever Pehlivan,&nbsp;Berk Alsancak,&nbsp;Suleyman Ozdemir,&nbsp;Ozgur Tarkan,&nbsp;Mustafa Mete Kiroglu","doi":"10.1016/j.bjorl.2025.101744","DOIUrl":"10.1016/j.bjorl.2025.101744","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates the prognostic significance of systemic inflammatory markers ‒ NLR, LMR, PLR, and SII ‒ in patients with SSNHL.</div></div><div><h3>Methods</h3><div>This retrospective study included 120 patients diagnosed with SSNHL at the Otolaryngology Department of Hospital. Medical records from both SSNHL and healthy control groups were reviewed to collect demographic data, pure tone audiometry results, and routine blood parameters. Hearing recovery was assessed at baseline and after two months using Siegel's criteria, and patients were categorized as either recovered (complete, partial, or slight recovery) or unrecovered.</div></div><div><h3>Results</h3><div>Compared to controls, SSNHL patients showed significantly elevated neutrophil counts, platelet levels, NLR, PLR, and SII values. Statistically significant differences were observed between recovered and unrecovered groups in neutrophil count (p = 0.021), lymphocyte count (p = 0.001), PDW (p = 0.042), NLR (p = 0.001), PLR (p = 0.001), LMR (p = 0.001), and SII (p = 0.001). Logistic regression analysis identified low LMR as a significant independent predictor of poor prognosis (R² = 0.271).</div></div><div><h3>Conclusion</h3><div>Elevated NLR, PLR, and SII values may reflect inflammatory processes and microvascular dysfunction in SSNHL. Among these, LMR emerged as a novel and potentially valuable prognostic biomarker for predicting treatment outcomes.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101744"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expectations Questionnaire for Adults with Cochlear Implants (EQA-CI): Translation, adaptation and cross-cultural validation to Brazilian Portuguese","authors":"Ingrid Barros Da Silva Santana ,&nbsp;Fernanda Ferreira Caldas ,&nbsp;Carolina Costa Cardoso ,&nbsp;Francisco Wallison Lucena da Silva ,&nbsp;Rayssa Pacheco Brito Dourado ,&nbsp;Fayez Bahmad Jr","doi":"10.1016/j.bjorl.2025.101717","DOIUrl":"10.1016/j.bjorl.2025.101717","url":null,"abstract":"<div><h3>Objective</h3><div>To translate, culturally adapt and validate the <em>Cuestionário de Expectativas</em> (CEA) for the Brazilian context, with focus on assessing the expectations of patients during pre-surgical stage.</div></div><div><h3>Methods</h3><div>An analytical and descriptive study was carried out, including translation, back-translation, adaptation and validation of the CEA. The process involved 119 participants who answered the questionnaire, allowing the analysis of understanding of the items using the Content Validity Index (CVI) and Exploratory Factor Analysis (EFA). Reliability was assessed with Cronbach's Alpha, McDonald's Omega and Composite Reliability coefficients, using Item Response Theory (IRT).</div></div><div><h3>Results</h3><div>The questionnaire had a total CVI of 0.974, indicating good comprehension by the participants, as well as high values for three internal consistency coefficients (⍺ = 0.828; ω = 0.854; CC = 0.900). The instrument showed great consistency indices and validity measures to be applied on a large scale.</div></div><div><h3>Conclusion</h3><div>The validity and reliability of the instrument were confirmed. Therefore, the instrument was translated, adapted and validated for Brazilian Portuguese.</div></div><div><h3>Levels of evidence</h3><div>Step 2.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101717"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis on the plane and mechanism of tongue-originated obstruction in Obstructive Sleep Apnea Syndrome (OSAS) patients with macroglossia","authors":"Min Huang ,&nbsp;Guohao Chen","doi":"10.1016/j.bjorl.2025.101709","DOIUrl":"10.1016/j.bjorl.2025.101709","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the plane and related mechanisms of tongue-originated obstruction in Obstructive Sleep Apnea Syndrome (OSAS) patients with macroglossia, utilizing pharyngeal Magnetic Resonance Imaging (MRI) in combination with Upper Airway Pressure Monitoring (UAPM).</div></div><div><h3>Methods</h3><div>Nineteen OSAS patients with macroglossia and 19 healthy controls were enrolled in this study. Every case was examined by pharyngeal MRI and Polysomnogram (PSG). The minimum Retropalatal Space (RP), the minimum Retrolingual Space (RL), soft palate thickness and the minimum space from the dorsal tongue to the soft palate (TP) were measured on a midsagittal plane. UAPM was measured only in the OSAS group. The differences of results between groups were statistically analyzed.</div></div><div><h3>Results</h3><div>Both UAPM and pharyngeal MRI indicated that the obstruction plane was present in patients with OSAS along the velopharyngeal plane. The mean values of both RP and RP/RL of patients with OSAS in this study were significantly smaller than control group values (<em>p</em> &lt; 0.05). There was no significant difference in RL and soft palate thickness across the two groups (<em>p</em> &gt; 0.05). The value of TP in both groups was close to 0, showing no significant difference between groups (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>The velopharyngeal plane was the most common site demonstrating obstructive etiology in OSAS patients with macroglossia. The related mechanism is suspected to include the backward movement of the soft palate caused by the high arch and the fall of the middle segment of the hypertrophic tongue. These findings may inform tongue-related surgical site decision-making for OSAS patients with macroglossia.</div></div><div><h3>Level of evidence</h3><div>IV: Retrospective cohort study.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"92 1","pages":"Article 101709"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}