Indian Journal of Otolaryngology and Head and Neck Surgery最新文献

{"title":"Assessment of Treatment Efficacy in Patients with Chronic Tinnitus: An Ambispective Cohort Study.","authors":"Sakthimurugan Sankar, Raghul Sekar, Subagar Anbarasan, S Haritha","doi":"10.1007/s12070-025-05478-5","DOIUrl":"10.1007/s12070-025-05478-5","url":null,"abstract":"<p><strong>Introduction: </strong>Tinnitus, a subjective perception of sound without external stimuli, affects millions worldwide, impairing daily function and quality of life. The severity of tinnitus is influenced by associated symptoms such as stress, anxiety, depression, and insomnia. The Tinnitus Functional Index (TFI) is a validated tool for assessing tinnitus severity and treatment outcomes. Despite the lack of a definitive cure, multimodal treatments, including pharmacotherapy and Tinnitus Retraining Therapy (TRT), show promise in managing the condition.</p><p><strong>Aim: </strong>This ambispective cohort study aimed to evaluate treatment efficacy in chronic tinnitus patients without hearing loss, using the Tinnitus Functional Index (TFI) as an assessment tool.</p><p><strong>Methodology: </strong>Forty patients were divided into two groups: Group A received pharmacological treatment alone, while Group B received both pharmacological treatment and tinnitus retraining therapy (TRT). TFI scores were recorded at baseline, 3, 6, and 12 months.</p><p><strong>Results: </strong>Statistical analyses revealed significant improvements in TFI scores in both groups over time, with Group B demonstrating greater improvement, indicating the efficacy of TRT.</p><p><strong>Conclusion: </strong>Our findings underscore the importance of multimodal treatment approaches, particularly TRT, in managing chronic tinnitus without hearing loss. Further research is warranted to refine treatment protocols and enhance patient outcomes.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2277-2282"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Ecchymosis and Edema after Rhinoplasty: Changes in Perioperative Inflammation Indixes.","authors":"Ali Genç, Elif Kaya Çelik, Ahmet Tuğrul Şahin, Vildan Kölükçü, Mehtap Gürler Balta, Gülçin Uysal, Hakan Tapar, Tuğba Karaman, Serkan Karaman","doi":"10.1007/s12070-025-05489-2","DOIUrl":"10.1007/s12070-025-05489-2","url":null,"abstract":"<p><p>This study aimed to investigate perioperative changes in the systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) and their relationship with postoperative edema and ecchymosis following rhinoplasty. This study was approved by the Ethics Committee of Tokat Gaziosmanpasa University (2024/No: 24-KAEK-185). This prospective observational study included 94 patients who underwent open rhinoplasty under general anesthesia. The study evaluated the relationship between changes in SII (ΔSII) and SIRI (ΔSIRI), calculated from hemogram tests performed 2 h before and 2 h after surgery, and the severity of periorbital edema and ecchymosis in the early and late postoperative periods. The ΔSII value was significantly higher in the severe edema group compared with the minimal/moderate edema group in both the early and late postoperative periods (<i>p</i> = 0.003, <i>p</i> = 0.03, respectively). In addition, ΔSII was significantly higher in the severe ecchymosis group than in the minimal/moderate ecchymosis group in the early postoperative period (<i>p</i> = 0.03). The ΔSIRI value was significantly higher in the severe edema and ecchymosis groups compared with the minimal/moderate groups in the early postoperative period (<i>p</i> = 0.04, <i>p</i> = 0.01, respectively). This study demonstrated a significant association between perioperative changes in SII and SIRI and the severity of periorbital edema and ecchymosis following open rhinoplasty. These indices may serve as valuable markers for predicting the extent of postoperative inflammatory responses in rhinoplasty patients.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2293-2300"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomised Comparative Study of 3% Hypertonic Saline Versus 0.5% Diluted Betadine Nasal Irrigation in the Post Operative Cases Of Functional Endoscopic Sinus Surgery.","authors":"Anil S Harugop, Tanishtha Saxena, Divit Goel, Lavanya Arjunan","doi":"10.1007/s12070-025-05497-2","DOIUrl":"10.1007/s12070-025-05497-2","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic Rhinosinusitis (CRS) is a disease characterized by persistent inflammation of the nasal and paranasal sinuses. It is well known that using hypertonic saline, diluted betadine saline, and normal saline improves mucociliary clearance¹. This study aimed to compare efficacy of 3% hypertonic saline nasal irrigation against 0.5% diluted betadine saline nasal irrigation in the postoperative period sinonasal outcome (SNOT 22) questionnaire.</p><p><strong>Objective: </strong>To assess the impact of 3% hypertonic saline and 0.5% betadine solution nasal irrigation\" on the \"QUALITY OF LIFE\" using the sinonasal outcome (SNOT 22) questionnaire.</p><p><strong>Methodology: </strong>A one year study with a sample size of 102 (51 in each group) assess the impact of 3% hypertonic saline and 0.5% betadine solution nasal irrigation\" on the \"QUALITY OF LIFE\" at 1st week, 1st month and 3rd month.</p><p><strong>Results: </strong>The study showed significant difference at the end of 1st week and 1st month in both groups proving betadine solution to be slightly better whereas in the 3rd month the hypertonic saline showed better results.</p><p><strong>Conclusion: </strong>This study concludes that that both 0.5% betadine solution and 3% hypertonic saline are equally significant with 3% hypertonic saline having slightly better results, where 0.5% diluted betadine solution has proven to be slightly better in the short-term treatment up to 1 month, and 3% hypertonic saline proved to be better in a long-term treatment upto 3 months.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2326-2331"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Deep Neck Infection Associated with COVID: Etiology - Cytomegalovirus.","authors":"Şeyda Akbal Çufalı, Kürşat Murat Özcan, Ayşe Seçil Kayalı Dinç, Ayşe Yasemin Tezer Tekçe, Ömer Faruk Çufalı, Abdulkerim Taşdemir","doi":"10.1007/s12070-025-05529-x","DOIUrl":"10.1007/s12070-025-05529-x","url":null,"abstract":"<p><p>Deep neck infections can progress from the oral cavity and oropharynx to the posterior cervical region or mediastinum, often leading to life-threatening complications. These infections are primarily caused by bacterial pathogens, and treatment is usually directed against the bacteria and occasionally against the fungi. This article presents the cases of two geriatric patients with diabetes mellitus and a history of coronavirus disease 2019 (COVID-19). Both patients developed deep neck infections unresponsive to antibiotic and antifungal therapy with a unique progression pattern. Although they were negative for CMV IgM in blood tests, their CMV positivity was confirmed by tissue samples. After initiation of antiviral therapy, clinical improvement was achieved. Cytomegalovirus (CMV) should be considered as a potential causative agent of treatment-resistant deep neck infections, especially in patients with previous CMV exposure and immunosuppression. Tissue sampling and molecular diagnostics, such as CMV DNA PCR, play a crucial role in identifying rare pathogens when conventional tests are negative.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2425-2429"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intriguing Cases of Diffuse Large B Cell Lymphoma in Paranasal Sinuses with Review of Literature.","authors":"Silky, Ashish Chandra Agarwal, Nuzhat Hussain, Vineet Kumar","doi":"10.1007/s12070-025-05505-5","DOIUrl":"10.1007/s12070-025-05505-5","url":null,"abstract":"<p><p>Diffuse Large B-Cell Lymphoma (DLBCL) of the paranasal sinuses (PNS) is an uncommon manifestation of non-Hodgkin lymphoma (NHL), accounting for 0.2-2% of all DLBCL cases. Despite DLBCL being the most frequent subtype of NHL, its occurrence in the PNS is rare, often leading to diagnostic delays due to nonspecific symptoms. The disease primarily affects older adults with a slight male predominance and presents with nasal obstruction, proptosis, and vision loss, among other symptoms. Diagnosis is challenging due to its similarity to more common sinonasal conditions like sinusitis, and timely identification is crucial given DLBCL's aggressive nature. This report presents three cases of DLBCL in the PNS, each characterized by progressive symptoms such as headache, nasal discharge, proptosis, and vision loss. All three patients were treated in a tertiary care center in North India. In each case, diagnostic imaging, histopathological examination, and immunohistochemical staining were utilized to confirm DLBCL. The patients underwent endoscopic biopsy and received chemotherapy, with varying degrees of response. Treatment challenges, particularly in patients with advanced disease, were highlighted, including the potentialfor irreversible vision loss and the high risk of relapse. A literature review further supports that DLBCL of the PNS is a rare but significant diagnosis requiring prompt recognition and treatment. Review of similar cases emphasizes the importance of distinguishing this condition from other sinonasal tumorsand infections to ensure proper management and improved patient outcomes.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2438-2441"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Clinical/ Endocrinal Surrogates Predict Specific Hormone Therapy in Nasopharyngeal Angiofibroma? Current Evidence.","authors":"Preetam Pathak, Anupam Mishra, Subhash C Mishra","doi":"10.1007/s12070-025-05487-4","DOIUrl":"10.1007/s12070-025-05487-4","url":null,"abstract":"<p><p>Objective: In an attempt to rationalize Hormone therapy (HT) in juvenile nasopharyngeal angiofibroma (JNA) this study intends to investigate the pituitary axis and clinical profile to further establish dominant hormonal-environment based upon secondary sexual characteristics along with other novel possibilities for HT. Design: Prospective observational study. Setting: Tertiary health care centre. Participants: Thirty-three patients were analysed in terms of age, secondary sexual characteristics (SSC), staging, preoperative serum-hormone profile and weight/ volume of excised tumour. Main outcome measures: Serum levels of prolactin, testosterone, oestrogens, progesterone, LH and secondary sexual characteristics. Results: Significant correlation was seen between LH/ testosterone/ estrogen on one hand while LH/ GH/ progesterone on other. LH/ testosterone correlated with age, tumour weight, & almost all SSC. Oestrogen correlated with age, & all SSC (except facial hair/ laryngeal prominence/ deepening of voice). Accordingly, 2 sets of SSC (clinical surrogate markers) defined estrogenic or androgenic predominance in JNA. Conclusions: The clinical surrogates may indirectly reflect corresponding receptor activity (rather than isolated hormone level) and provide a better rationale for selecting a particular HT.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12070-025-05487-4.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2283-2292"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulating a Bloodless Surgical Field: A Study on Varying Relationship of Internal Jugular Vein and Common Carotid Artery with Neck Rotation.","authors":"Parnini Goswami, Rajendra B Metgudmath","doi":"10.1007/s12070-025-05459-8","DOIUrl":"10.1007/s12070-025-05459-8","url":null,"abstract":"<p><p>To evaluate the intervarying relationship of IJV and CCA at supine and after simulating rotation to 15, 30 and 45 degrees respectively. A one year study was undertaken and 104 IJVs were evaluated at supine and after simulating 15-, 30- and 45-degree neck rotation to the contralateral side.The study had a male predilection of 68.63% over 33.33% females. Prior to simulating rotation, the IJV was Anterolateral (42%), Lateral (39%), Posterolateral (22%), Posterior (1%) and with subsequent rotation it assumed a more anterior relationship. The mean overlap of IJV and CCA was 27.7 at 0 degree, 32.93 at 15 degrees, 37.73 at 30 degree and 37.81 at 45-degree neck rotation and 26.7 at 0 degree, 29.24 at 15 degrees, 35.58 at 30 degree and 31.52 at 45-degree neck rotation on left; thereby showing increasing overlap with rotation.Special attention should be paid to anterior shifting of IJV relative to CCA induced with neck rotation. Taking this knowledge into account in the operative field can minimize surgical errors and intra operative complications.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2247-2251"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Completely Endoscopic Versus Microscopic Mastoid Surgery for Chronic Otitis Media with Cholesteatoma: A Randomized Controlled Trial.","authors":"Aswathi Kallyadan Veetil, Saurav Sarkar, Pradeep Pradhan, Vinusree Karakkandy, Anindya Nayak, Pradipta Kumar Parida, Preetam Chappity, Dillip Kumar Samal, Aswini Saravanan, Abhishek Anil","doi":"10.1007/s12070-025-05466-9","DOIUrl":"10.1007/s12070-025-05466-9","url":null,"abstract":"<p><p>Complete eradication of cholesteatoma and restoration of best possible hearing is the surgeons' goal for Chronic otitis media (COM) with cholesteatoma. For patients with chronic otitis media and cholesteatoma, the traditional surgical approach has been performed using a microscope. However, over the past 20 years, endoscopic ear surgery has evolved into a promising alternative technique. This study aimed to compare Completely endoscopic mastoid surgery (CEMS) to microscopic surgery in COM patients with cholesteatoma.This randomized controlled trial was conducted in a tertiary referral center from July 2019 to July 2021. Patients with squamous-type COM and cholesteatoma, meeting predefined inclusion criteria, were enrolled after block randomization. Endoscopic and microscopic mastoidectomies were performed in intervention and control groups respectively. The primary outcome was to compare the improvement in hearing, while secondary outcomes were duration of surgery, postoperative pain score, duration of hospital stay, recidivism rate during the study period, quality of life, and cosmesis.The study included 40 individuals with 20 patients in each group, and had well-matched demographics and disease characteristics. The mean pre-operative air conduction pure tone average reduced from 37.51 ± 5.41 dB to 30.62 ± 7.04 dB in the endoscopic group and from 43.46 ± 5.80 dB to 33.83 ± 5.99 dB in the microscopic group. Both groups yielded comparable post-operative hearing improvements, as well as no significant differences in surgical duration. However, CEMS demonstrated significantly lower postoperative pain scores (<i>p </i>= 0.0002) and shorter hospital stays (<i>p</i> = 0.013). Quality of life scores improved significantly in the CEMS group postoperatively (<i>p</i> = 0.021), with higher patient satisfaction regarding cosmesis.Endoscopic ear surgery emerges as an excellent alternative to microscopic ear surgery for addressing the squamous type of chronic otitis media with cholesteatoma. It not only holds promise for improved hearing outcomes but also offers the benefits of reduced post-operative pain, shorter hospital stays, enhanced cosmesis, and better patient satisfaction.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12070-025-05466-9.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2260-2270"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salivary Gland Scintigraphy in Parotid-Sparing IMRT for H&N Cancer: Trend of Function Recovery.","authors":"Alessia Reali, Tiziana Angusti, Edoardo Trevisiol, Simona Allis, Roberta Verna, Lavinia Bianco, Maria Grazia Ruo Redda","doi":"10.1007/s12070-025-05401-y","DOIUrl":"10.1007/s12070-025-05401-y","url":null,"abstract":"<p><p>The recovery of parotid gland function following radiotherapy for head and neck (H&N) cancer has a significant impact on the quality of life (QOL) of patients, with strong correlations between salivary output and mean radiation dose received by the parotid glands. Salivary gland scintigraphy (SGdS) is a valuable tool for assessing salivary gland functionality. Our case reports demonstrates that parotid glands that were spared during RT undergo a transitional phase of hypofunctionality as observed in SGdS assessments. These findings suggest that even spared parotid glands may experience temporary functional impairment, which could have implications for patient management and expectations for recovery post-treatment.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12070-025-05401-y.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2384-2386"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Surgical Bed Versus Tumor Margins in Trans-Oral Resection of Early Glottic Cancer.","authors":"Tom Jacob, Narin Nard Carmel Neiderman, Yotam Lior, Anton Warshavsky, Gilad Horowitz, Oshri Wasserzug, Leonore Trejo, Nidal Muhanna, Yael Oestreicher-Kedem","doi":"10.1007/s12070-025-05469-6","DOIUrl":"10.1007/s12070-025-05469-6","url":null,"abstract":"<p><p>To assess which margin status, surgical bed margin (SBM) or tumor margin (TM) correlates best with outcome following transoral laser microsurgery (TLM) for early (Tis-T2N0M0) glottic cancer. A retrospective cohort study including patients with early (T1-2) glottic cancer. Data on TM status, SBM status, recurrence rate, and disease-free survival (DFS) were retrieved from the medical records of all patients who underwent vocal fold (VF) cordectomy due to Tis-T2N0M0 glottic squamous cell carcinoma from January 2013 to February 2021. Only patients with available data on both SBM and TM status were included in the study. Forty patients, 34 (85%) with disease-free SBM and TM, and 6 (15%) with disease-free SBM but involved TM, were included. Four (10%) patients developed recurrence, all in the group of both disease-free SBM and TM. The recurrence, 2-year disease free survival and survival at the end of follow-up (median 37.5 months) rates were 11%, 94.1% and 97.1% and 0%, 100% and 100%, in the groups of disease-free SBM and TM and disease-free SBM but involved TM, respectively. There were no statistically significant group differences. TM involvement, in the presence of disease-free SBM, did not compromise outcome.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2271-2276"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}