Auris Nasus Larynx最新文献

{"title":"Epstein-Barr virus (EBV) reactivation in post COVID-19","authors":"Eslam Farid Abu Shady ,&nbsp;Abdelhakim Fouad Ghallab ,&nbsp;Doaa Abdullah Shaker ,&nbsp;Rasha Abd Elhamid Elsayed","doi":"10.1016/j.anl.2025.06.009","DOIUrl":"10.1016/j.anl.2025.06.009","url":null,"abstract":"<div><h3>Objective</h3><div>To determine if there is a link between prolonged COVID symptoms and the reactivation of EBV.</div></div><div><h3>Methods</h3><div>This study was an observational (case-control) analysis involving 140 patients who tested positive for COVID-19 and are experiencing persistent symptoms such as fatigue and post-exertional malaise. Additionally, a control group of 80 individuals, matched for age and gender, who have fully recovered from SARS-CoV-2 infection without these symptoms, was included. The research took place between December 2023 and March 2024 at Benha University Hospitals in Benha, Egypt. The reactivation of the Epstein–Barr virus (EBV) was identified by detecting EBV genetic material using TaqMan probes, along with at least one set of primers (<em>Bam</em>HI and LMP2).</div></div><div><h3>Results</h3><div>Initial hospitalization during acute COVID-19 infection is significantly associated with post-COVID fatigue <strong><em>(p-value 0.007*)</em></strong>. No significant associations were found for risk factors like diabetes and hypertension. EBV replication observed was due to EBV reactivation rather than primary infection. EBV-specific antibody titers EBNA-1 IgG (p-value 0.004*) and EA-D IgG <strong><em>(p-value 0.008*)</em></strong>. 40/140 (28.6 %) patients with COVID-19 with persistent fatigue showed EBV reactivation in contrast to 9/80 (11.3 %) of controls <strong><em>(P-value 0.003*)</em></strong> using the same detection methods.</div></div><div><h3>Conclusion</h3><div>EBV reactivation plays a role in Long-COVID syndrome following COVID-19 infection supporting the usage of EBV inhibitors for long-term COVID-19 treatment.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 442-446"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481446","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":"Biphenotypic sinonasal sarcoma: Report of two cases treated with carbon-ion radiotherapy","authors":"Kaoru Takahashi ,&nbsp;Masato Shino ,&nbsp;Kazuaki Chikamatsu","doi":"10.1016/j.anl.2025.06.005","DOIUrl":"10.1016/j.anl.2025.06.005","url":null,"abstract":"<div><div>Biphenotypic sinonasal sarcoma (BSNS) is a rare tumor characterized by dual differentiation into muscular and neural lineages. Herein, we describe two cases of BSNS treated with carbon-ion radiotherapy. The first case involves an 83-year-old woman who presented with a tumor filling the left nasal cavity. Imaging studies showed a mass occupying the left nasal cavity and ethmoidal sinus, but no cervical lymph node or distant metastases were identified. Immunohistochemical staining revealed positivity for αSMA (smooth muscle actin) and S-100, while SOX-10 was negative, suggesting a diagnosis of BSNS. Additionally, a PAX3-MAML3 fusion gene was identified. The second case involves a 74-year-old man who presented with right buccal swelling due to a tumor in the right nasal vestibule. Imaging studies revealed a mass in the right nasal vestibule extending into the maxillary sinus. Immunohistochemistry showed positivity for αSMA and S-100 but negativity for SOX-10, confirming a diagnosis of BSNS. However, none of the three tested PAX3 fusion genes were detected in this case. Both patients were treated with carbon-ion radiotherapy, which demonstrated favorable therapeutic effects. Carbon-ion radiotherapy may be a potential therapeutic option for patients with BSNS.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 447-450"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490035","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":"Prevalence of sleep-disordered breathing in patients who underwent endoscopic nasal sinus surgery: investigation of nasal obstruction as a risk factor for sleep-disordered breathing","authors":"Masaaki Suzuki ,&nbsp;Mao Kamei ,&nbsp;Ryo Kuboki ,&nbsp;Yuichi Kawai ,&nbsp;Ryosuke Kotani","doi":"10.1016/j.anl.2025.05.007","DOIUrl":"10.1016/j.anl.2025.05.007","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the prevalence of sleep-disordered breathing (SDB) in patients with nasal diseases who underwent endoscopic nasal sinus surgery (ESS) compared with control patients without nasal disease who underwent tonsillectomy.</div></div><div><h3>Methods</h3><div>An observational retrospective case-control study was conducted of 150 adults with nasal diseases who underwent ESS (ESS group) as well as 94 adults with no nasal symptoms or diseases who underwent tonsillectomy due to infection of the tonsils (tonsillectomy group). Patients with obstructive sleep apnea, patients with a chief complaint of snoring or excessive daytime sleepiness, or patients having large tonsils were excluded from the study. Home sleep apnea testing was performed prior to admission for surgery.</div></div><div><h3>Results</h3><div>The prevalence in normal, mild, moderate, and severe SDB was respectively 30.0 %, 38.0 %, 22.7 %, and 9.3 % in the ESS group and 50.0 %, 39.4 %, 10.6 %, and 0 % in the tonsillectomy group. There were significant differences in the mean 3 % oxygen desaturation index (3 %ODI) score between the ESS and tonsillectomy groups in men but not in women. Obese men in the ESS group were much more susceptible to having moderate or severe SDB when they were aged ≥40 years. Regression analysis revealed that the preoperative 3 %ODI score had two significant determinants in the ESS group—BMI and male sex—whereas age, nasal resistance, and CRS with nasal polyps were not significant predictors.</div></div><div><h3>Conclusions</h3><div>Among patients who underwent ESS, 32.0 % had moderate to severe SDB, including 9.3 % with severe SDB. Nasal obstruction could be a potential risk factor for SDB in male patients.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 451-455"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490034","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":"Practical guideline for the management of allergic rhinitis in Japan 2024","authors":"Mitsuhiro Okano ,&nbsp;Kimihiro Okubo ,&nbsp;Minoru Gotoh ,&nbsp;Mikiya Asako ,&nbsp;Nobuo Ohta ,&nbsp;Atsushi Kamijo ,&nbsp;Kayoko Kawashima ,&nbsp;Masafumi Sakashita ,&nbsp;Daiju Sakurai ,&nbsp;Tetsuya Terada ,&nbsp;Yuji Nakamaru ,&nbsp;Takechiyo Yamada ,&nbsp;Shuji Yonekura ,&nbsp;Aiko Oka ,&nbsp;Marie Yamada ,&nbsp;Tomokazu Yoshizaki","doi":"10.1016/j.anl.2025.05.005","DOIUrl":"10.1016/j.anl.2025.05.005","url":null,"abstract":"<div><div>The Practical Guideline for the Management of Allergic Rhinitis in Japan was first published in 1993. After the COVID-19 pandemic, the current 10th edition was published in 2024. The most recent collection of evidence from the literature, such as the sustained post-treatment effect of sublingual immunotherapy on Japanese cedar pollinosis, was added to the revised guideline, which incorporates evidence-based medicine. In this revised guideline, a diagram illustrating the pathogenesis of allergic rhinitis and the mechanisms of action of various pharmacological treatments has been added. Also included is a diagram that shows the mechanism of action of allergen immunotherapy and a more detailed description of the oral allergy syndrome. The clinical question and answer section was also revised along with the introduction of new questions, such as: Does anti-IgE antibody treatment effectively reduce the symptoms of severe seasonal allergic rhinitis? Also updated was the evidence-based step-by-step strategy for treatment.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 426-441"},"PeriodicalIF":1.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144331237","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":"Development of a vestibular implant for otolith stimulation: A mouse model study","authors":"Toru Miwa ,&nbsp;Teppei Kouga ,&nbsp;Taku Ito ,&nbsp;Akihito Tarui ,&nbsp;Yasunori Asai ,&nbsp;Taro Fujikawa ,&nbsp;Hideaki Ogita ,&nbsp;Takeshi Tsutsumi ,&nbsp;Nobuhiro Hakuba","doi":"10.1016/j.anl.2025.06.007","DOIUrl":"10.1016/j.anl.2025.06.007","url":null,"abstract":"<div><h3>Objective</h3><div>Worldwide, bilateral vestibulopathy (BVH) affects ≈1.8 million adults. Its symptoms include oscillopsia, postural instability, and gait disturbances, which significantly impair the patient’s quality of life. Despite advancements in vestibular rehabilitation, these approaches remain supportive and cannot restore vestibular function. We aimed to evaluate the efficacy of a vestibular implant targeting the utricle and saccule in a mouse model of BVH.</div></div><div><h3>Methods</h3><div>A total of 30 CBA/J mice underwent bilateral vestibular destruction, followed by implantation of a vestibular implant in the left ear. Of these, we selected 14 mice for analysis and divided them into three groups: no stimulation (vestibular destruction + implantation), 0.5V stimulation, and 1.0V stimulation groups. No intervention group was used as a control. Eye movement and behavioral analyses, including otolith-ocular reflex (OOR), vestibulo-ocular reflex (VOR), and gait assessments, were performed after 2 post-intervention weeks.</div></div><div><h3>Results</h3><div>Artificial vestibular stimulation significantly improved OOR responses, with 1.0V stimulation restoring vertical eye rotation angles to levels comparable to those in controls (p &lt; 0.001). However, VOR gain remained impaired across all groups. Behavioral analysis revealed significantly reduced trunk deviation with 1.0V stimulation, with scores similar to those in the control group (p &lt; 0.001). There was partial recovery of gait parameters, with stimulated groups showing a narrower base of support (<em>p</em> &lt; 0.05); however, there was no significant improvement in stride length and speed.</div></div><div><h3>Conclusion</h3><div>Our findings indicated that targeted stimulation of the utricle and saccule via a vestibular implant can partially restore otolithic function, reduce trunk deviation, and improve gait stability in a mouse model of BVH. Despite the promising efficacy of chronic stimulation for functional recovery, it is important to further refine the stimulation parameters and electrode design, as well as determine the systemic effects. Our findings may inform the development of head-mounted vestibular prostheses for clinical application in patients with bilateral vestibular dysfunction.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 412-419"},"PeriodicalIF":1.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322108","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":"Effects of simulated cochlear implant listening on postural control in typical-hearing adults","authors":"Semire Ozdemir ,&nbsp;Merve Ozbal Batuk ,&nbsp;Hilal Dincer D’Alessandro ,&nbsp;Gonca Sennaroglu","doi":"10.1016/j.anl.2025.06.001","DOIUrl":"10.1016/j.anl.2025.06.001","url":null,"abstract":"<div><h3>Objective</h3><div>Heightened listening effort in cochlear implant (CI) users may have a significant impact on their balance performance. This study aims to investigate the impact of listening effort on postural control in typical-hearing adults presented with CI-simulated speech in noise.</div></div><div><h3>Methods</h3><div>The study participants were fifty-eight adults with typical hearing (aged 20–24 years). Turkish Hearing in Noise Test (HINT) sentences were used as the speech material. The Modified Clinical Test of Sensory Interaction in Balance (mCTSIB) was used to evaluate static balance and it was performed by using Computerized Static Posturography. In the experimental design of the study, healthy participants with typical hearing listened to non-simulated and CI-simulated sentences and repeated what they heard while the participants were performing the mCTSIB test on the force platform of static posturography.</div></div><div><h3>Results</h3><div>In this study, the participants' postural sway velocity rates were compared under three task conditions. The results demonstrated a statistically significant increase in participants' sway velocity rates when listening to 12-channel filtered speech in noise material compared to those from the baseline mCTSIB assessment. There was no statistically significant differences in postural sway rate ratios when listening to unfiltered speech in noise material.</div></div><div><h3>Conclusion</h3><div>Increased listening effort for CI-simulated speech-in-noise resulted in poorer postural balance. A better understanding of such a difficulty may help us to evaluate postural balance from different perspectives and plan an appropriate vestibular rehabilitation program.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 420-425"},"PeriodicalIF":1.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144331236","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":"Running pattern of the internal maxillary artery assessed using arterial-phase CT images in 434 sides in Japanese individuals","authors":"Nayuta Tsushima ,&nbsp;Satoshi Kano ,&nbsp;Takayoshi Suzuki ,&nbsp;Seijiro Hamada ,&nbsp;Hiroshi Idogawa ,&nbsp;Ryohei Katsumata ,&nbsp;Akihiro Homma","doi":"10.1016/j.anl.2025.06.003","DOIUrl":"10.1016/j.anl.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>The internal maxillary artery (IMA) follows two primary running patterns: lateral, where it traverses the superficial layer of the lateral pterygoid muscle, and medial, where it passes through the deep layer. The frequency of these patterns varies among populations, with the medial type reported in 6–18 % of Asians and 37–46 % of Caucasians. Ligation of the IMA, commonly performed during total or partial maxillectomy to reduce bleeding, is more challenging in the medial type due to its deeper anatomical position. Therefore, preoperative identification of its pattern is crucial. This study analyzed the IMA running pattern in Japanese individuals using arterial-phase CT and the diagnostic accuracy of standard contrast-enhanced CT.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 434 sides from 217 Japanese individuals who underwent arterial-phase CT. The IMA was classified as lateral or medial based on its relationship with the lateral pterygoid muscle. We evaluated whether the running pattern was influenced by anatomical side, gender, or the side of tumor involvement using Fisher’s exact test. In 213 patients, arterial-phase CT findings were compared with standard contrast-enhanced CT.</div></div><div><h3>Results</h3><div>The lateral and medial types were observed in 94 % (407 sides) and 6.2 % (27 sides), respectively. No significant differences were found between anatomical sides (<em>p</em> = 0.11), gender (<em>p</em> = 0.092), or tumor involvement (<em>p</em> = 0.57), though symmetry was significant (<em>p</em> = 0.003). Standard contrast-enhanced CT showed 97.4 % concordance with arterial-phase CT but misclassified 17 % of medial cases.</div></div><div><h3>Conclusion</h3><div>The lateral type was predominant in Japanese individuals. Preoperative assessment of the IMA using arterial-phase CT is recommended when standard CT is inconclusive. Accurate identification can improve surgical precision and reduce complications.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 398-403"},"PeriodicalIF":1.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312566","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":"Relationship between autonomic nervous system function and endolymphatic space ratio in Ménière disease","authors":"Keita Ueda ,&nbsp;Tomoyuki Shiozaki ,&nbsp;Hiroshi Inui ,&nbsp;Tsuyoshi Sakamoto ,&nbsp;Tadashi Kitahara","doi":"10.1016/j.anl.2025.06.002","DOIUrl":"10.1016/j.anl.2025.06.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Autonomic dysfunction is associated with Ménière disease (MD) and benign paroxysmal positional vertigo (BPPV). Because the autonomic nervous system regulates blood pressure (BP) and heart rate (HR) during positional changes, these changes can be used to assess autonomic nervous system function. We aimed to evaluate the relationship between MD/BPPV and autonomic nervous system function based on BP, HR, and endolymphatic space (ELS) ratio measurements, and to examine the differences between the two diseases.</div></div><div><h3>Methods</h3><div>This retrospective study included 168 patients who underwent inner ear magnetic resonance imaging (MRI), Schellong test (S-test), and HR measurements and were diagnosed with MD (<em>n</em> = 103) or BPPV (<em>n</em> = 65) between August 2014 and January 2024. The ELS ratios of the entire inner ear, cochlea, vestibule, and semicircular canals were calculated using MRI. The ranges of BP and HR changes during position changes were calculated and related to each ELS ratio.</div></div><div><h3>Results</h3><div>Forty (38.8 %) patients with MD had a positive S-test result, which was significantly higher than the number of patients with BPPV who had a positive S-test result (<em>n</em> = 15, 23.1 %) (<em>P</em> = 0.0427, Fisher’s exact test). A trend toward a significant increase in the cochlear ELS ratio with decreasing systolic BP was observed in patients with MD with a positive S-test (Spearman’s test, <em>r</em>=−0.346, <em>P</em> = 0.0287). No significant differences were observed between the other combination groups.</div></div><div><h3>Conclusion</h3><div>Autonomic nervous system function may influence the onset of MD more than BPPV, furthermore, MD patients with S-test positive, a weak correlation was observed between an increased ELS ratio in the cochlear and a decrease in systolic BP.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 404-411"},"PeriodicalIF":1.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312762","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":"Interstitial pneumonia caused by Photoimmunotherapy with cetuximab-IR700 conjugate","authors":"Yu Suekata ,&nbsp;Tomoyuki Otsuka ,&nbsp;Takuya Asai ,&nbsp;Kenta Uemura ,&nbsp;Yoshiki Kojitani ,&nbsp;Mizuki Korematsu ,&nbsp;Koji Kitamura ,&nbsp;Junji Miyabe ,&nbsp;Minako Nishio ,&nbsp;Toshihiro Kudo ,&nbsp;Takashi Fujii","doi":"10.1016/j.anl.2025.06.008","DOIUrl":"10.1016/j.anl.2025.06.008","url":null,"abstract":"<div><div>Photoimmunotherapy (PIT) is a newly developed cancer therapy that uses the tumor-targeted monoclonal antibody cetuximab conjugated to the photoabsorbing dye IR700. It is currently approved for the treatment of unresectable, locally advanced, or locoregionally recurrent head and neck cancers in Japan. However, data regarding the clinical safety of PIT are currently limited in the literature. Herein, we report the case of a 70-year-old man with nasopharyngeal squamous cell carcinoma who developed interstitial pneumonia after receiving PIT. He developed a fever 3 days after PIT, and computed tomography revealed ground-glass opacities in both lungs. He was diagnosed with drug-induced interstitial pneumonia, and subsequently responded well to prednisolone therapy. This case highlights the potential risk of interstitial pneumonia associated with the cetuximab-IR700 conjugate used in PIT. Clinicians should consider the possibility of interstitial lung disease whenever fever persists following PIT. Further studies are warranted to fully characterize the safety profile of PIT.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 394-397"},"PeriodicalIF":1.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312638","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":"Expiratory pressures generated by heat moisture exchangers in laryngectomized patients","authors":"Toshihiko Yamashita,&nbsp;Hirotaka Shinomiya,&nbsp;Ken-ichi Nibu","doi":"10.1016/j.anl.2025.05.010","DOIUrl":"10.1016/j.anl.2025.05.010","url":null,"abstract":"<div><h3>Objective</h3><div>HMEs (Heat and Moisture Exchangers) are used postoperatively in laryngectomized patients to replace upper airway functions such as heating, humidification, filtration and resistance that are lost by the surgery. The clinical value of HME resistance function is controversial. There are no studies reporting actual measurements of air pressure generated by HMEs during breathing. In this paper we evaluated air pressures generated by HMEs (XtraFlow^Ⓡ, XtraMoist^Ⓡ, LifeGo^Ⓡ, and LifeHome^Ⓡ. Atos Medical, Japan), compared the obtained data with theoretical pressure, and discussed the comparison with the expiratory pressure of pursed lips breathing reported in the past.</div></div><div><h3>Methods</h3><div>Nine patients who had laryngectomy were enrolled in this study. All participants were male, and the mean age was 72.3 ± 6.7. A pressure measurement system using a U-shaped water manometer was created to measure pressures generated by HMEs. Expiratory pressures were measured in all HMEs at rest and in XtraFlow^Ⓡ and LifeGo^Ⓡ during light exercise.</div></div><div><h3>Results</h3><div>Peak expiratory pressure was 5.67 mmH2O (95 %CI, 3.24 to 8.11) and time averaged expiratory pressure was 3.00 mmH2O (95 %CI, 1.56 to 4.45). These pressures were consistent with theoretical values. The finer HME, the higher pressure. The coarse filters had lower expiratory pressure but did not exceed the pressure from the fine filters even with the added pressure from the treadmill load (3Mets).</div></div><div><h3>Conclusion</h3><div>Endotracheal pressure was approximately less than 10 mmH2O during expiration in Atos HMEs. The fine filters, such as XtraMoist^Ⓡ and LifeHome^Ⓡ, had greater exhalation pressures than coarse filters such as XtraFlow^Ⓡ and LifeGo^Ⓡ. The pressure drops of HMEs seemed lower than the pressure drops added by pursed lips expiration and HMEs may not be a substitute for pursed lips expiration.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 388-393"},"PeriodicalIF":1.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280177","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}