Auris Nasus Larynx最新文献

{"title":"Speech-swallow dissociation in velopharyngeal closure for differentiating amyotrophic lateral sclerosis and myasthenia gravis","authors":"Hiroshi Yaguchi ,&nbsp;Shinji Miyagawa ,&nbsp;Ryoji Nakada ,&nbsp;Sumire Yamamoto ,&nbsp;Kenichi Sakuta","doi":"10.1016/j.anl.2025.03.003","DOIUrl":"10.1016/j.anl.2025.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>Speech-swallow dissociation (SSD) in velopharyngeal closure on laryngoscopy is a sign of pseudobulbar palsy. We hypothesized that this finding could differentiate amyotrophic lateral sclerosis (ALS) from myasthenia gravis (MG). This study aimed to identify laryngoscopic findings useful in differentiating these two diseases.</div></div><div><h3>Methods</h3><div>ALS and MG patients with bulbar symptoms who underwent fiberoptic laryngoscopy in our hospital were retrospectively examined. The following laryngoscopic items were evaluated: velopharyngeal incompetence (VPI) in phonation and swallowing, pharyngeal constriction, vocal cord movement, and salivary status.</div></div><div><h3>Results</h3><div>One hundred seven patients (70 with ALS and 37 with MG) were included for analysis. The prevalence of VPI in phonation was significantly higher in the ALS group (40 % vs. 19 %; <em>P</em> = 0.027). The prevalence of SSD in velopharyngeal closure was also significantly higher in the ALS group (33 % vs. 3 %; <em>P</em> &lt; 0.001). The other laryngoscopic findings did not differ between the groups. Multivariate logistic regression showed that SSD in velopharyngeal closure was independently associated with ALS (odds ratio, 26.64; 95 % confidence interval, 2.24–317.58; <em>P</em> = 0.009).</div></div><div><h3>Conclusion</h3><div>SSD in velopharyngeal closure is useful for differentiating ALS from MG.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 3","pages":"Pages 239-242"},"PeriodicalIF":1.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816356","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":"The impact of detecting and autotransplanting parathyroid gland with near-infrared imaging during total laryngectomy with total thyroidectomy","authors":"Takeshi Takahashi ,&nbsp;Kohei Otaki ,&nbsp;Shusuke Ohshima ,&nbsp;Yuto Takahashi ,&nbsp;Ryoko Tanaka ,&nbsp;Kohei Saijo ,&nbsp;Jo Omata ,&nbsp;Yusuke Yokoyama ,&nbsp;Ryusuke Shodo ,&nbsp;Yushi Ueki ,&nbsp;Keisuke Yamazaki ,&nbsp;Hiroshi Matsuyama ,&nbsp;Arata Horii","doi":"10.1016/j.anl.2025.03.004","DOIUrl":"10.1016/j.anl.2025.03.004","url":null,"abstract":"<div><h3>Objective</h3><div>Persistent postoperative hypoparathyroidism (hypoPT) after total thyroidectomy (TT) is a serious complication necessitating lifelong treatment. HypoPT would be more serious when combined with total laryngectomy (TL), since in situ preservation nor autotransplantation of parathyroid glands (PGs) is not always attempted. This study examined the accuracy of identifying PGs using near-infrared fluorescence imaging (NIFI) and assessed the oncological safety and impact of PG autotransplantation on hypoPT in TL+TT.</div></div><div><h3>Methods</h3><div>This prospective study was conducted between June 2020 and November 2023 at three hospitals in Niigata, Japan. Twelve patients who underwent TL+TT were included. Specimens were evaluated for autofluorescence (AF) using NIFI ex vivo followed by histological examination. Levels of albumin-corrected calcium and intact parathyroid hormone (PTH) were monitored postoperatively.</div></div><div><h3>Results</h3><div>Twenty-nine AF-positive tissues were identified as possible PGs using NIFI. Histological examination revealed that 27 were PGs and 2 were adipose tissues: 0–5 (median=2) PGs were autotransplanted per patient. All 272 tissues isolated as lymph nodes by the surgeon's visual inspection were negative for AF, none of which were PGs by histological examinations. Therefore, NIFI exhibited 100 % sensitivity and 99 % specificity for PG identification. The rate of persistent postoperative hypoPT was 33 % (4/12). After a median follow-up of 42 months (range 16–54 months), no tumor recurrence was observed in the sites of parathyroid autotransplantation.</div></div><div><h3>Conclusion</h3><div>This study demonstrated the high accuracy of NIFI in identifying PGs during TL+TT. PG autotransplantation with NIFI assistance emerged as a viable technique for mitigating postoperative hypoPT in TL+TT procedures.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 3","pages":"Pages 234-238"},"PeriodicalIF":1.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799399","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":"Detailed evaluation of the risk of infraorbital nerve injury in postoperative maxillary cyst surgery","authors":"Takashi Fukumura ,&nbsp;Kosuke Takabayashi ,&nbsp;Kosuke Akiyama ,&nbsp;Yasushi Samukawa ,&nbsp;Hiroshi Hoshikawa","doi":"10.1016/j.anl.2025.03.005","DOIUrl":"10.1016/j.anl.2025.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>Postoperative maxillary cyst (POMC) develops as a delayed complication after radical surgery. The infraorbital nerve (ION) is a terminal branch of the trigeminal nerve and is one of the low-frequency collateral injuries that may occur in maxillary sinus surgery. The risk of ION injury may increase during POMC surgery due to anatomical variations: however, this has not yet been examined in detail. Therefore, we herein investigated variations in the ION in POMC cases with a focus on its relationship with the aperture site of the cyst, to clarify the risk of injury.</div></div><div><h3>Methods</h3><div>A multifacility retrospective study was conducted between May 2014 and December 2023 on patients who underwent POMC surgery in Kagawa Medical University or Japanese Red Cross Asahikawa Hospital. Preoperative coronal CT images were reviewed from the viewpoint of anatomical variations in the ION and the risk of nerve injury.</div></div><div><h3>Results</h3><div>Eighty-four patients (95 sides), including 11 bilateral cases, were eligible. The presence of several risk factors for nerve injury was evaluated. The following outcomes were noted: contact between the opening site and ION (27.4 %), bony erosion of the infraorbital canal (35.8 %), descent of the ION from the orbital floor (16.8 %), and obscuration of the nerve run (17.9 %). The risk of injury was classified based on the results of imaging evaluations as follows: no risk (69 cases, 72.6 %), low risk (16 cases, 16.8 %), moderate risk (6 cases, 6.3 %), and high risk (4 cases, 4.2 %). A retrospective review revealed that ION injury occurred in only 1 patient (1.4 %) who was categorized as high risk.</div></div><div><h3>Conclusion</h3><div>Although the overall risk of ION injury is not very high, it is important to note that it may occur in some cases without precautions. Therefore, detailed CT with a focus on the ION to preoperatively assess the risk of nerve injury is important.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 3","pages":"Pages 229-233"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705714","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":"Association between the Hospital Anxiety and Depression Scale and Swallowing Function in Dysphagic Patients in Japan","authors":"Takuma Hisaoka ,&nbsp;Jun Suzuki ,&nbsp;Ryoukichi Ikeda ,&nbsp;Ai Hirano-Kawamoto ,&nbsp;Jun Ohta ,&nbsp;Yukio Katori","doi":"10.1016/j.anl.2025.03.001","DOIUrl":"10.1016/j.anl.2025.03.001","url":null,"abstract":"<div><h3>Objective</h3><div><strong>:</strong> Dysphagia affects 2.3 %–16 % of the general population and increases with age. It can lead to malnutrition, weight loss, aspiration pneumonia, and emotional symptoms such as anxiety and depression. Mental health disorders impact appetite and muscle mass, further worsening dysphagia. Additionally, cultural and economic factors influence anxiety and depression, which can either result from or contribute to dysphagia. Studies on the relationship between anxiety, depression, and swallowing function using FEES are limited in Asian populations. The Hospital Anxiety and Depression Scale (HADS) is a useful tool for assessing mood disorders. Therefore, in this study, we aimed to investigate the associations among anxiety, depression, and swallowing function in Japanese patients with dysphagia using HADS.</div></div><div><h3>Methods</h3><div><strong>:</strong> Data on age; sex; HADS; Eating Assessment Tool-10 (EAT-10); Functional Oral Intake Scale (FOIS); tongue pressure; Hyodo score, a scoring system for evaluating the swallowing function determined by flexible endoscopic evaluation of swallowing (FEES); and videofluoroscopic dysphagia scale (VDS), assessed by videofluoroscopic swallowing study, were collected and analyzed from medical records. Hyodo score consists of four parameters: (1) salivary pooling in the vallecula and piriform sinuses; (2) glottal closure reflex or cough reflex induced by touching the epiglottis or arytenoid; (3) swallowing reflex induced by colored water; and (4) extent of pharyngeal clearance after colored water is swallowed. The Mann–Whitney U test, Fisher's exact test, and multiple logistic regression analyses were used to estimate associations between HADS and swallowing function.</div></div><div><h3>Results</h3><div><strong>:</strong> No significant relationships were observed between the EAT-10, FOIS, and VDS with HADS scores. Patients with depression were associated with a significantly higher percentage of anorexia complaints (<em>p</em> = 0.047). Lower tongue pressure was observed in patients with depression than in patients without depression (<em>p</em> = 0.002). Patients with anxiety had better swallowing function, as assessed by the Hyodo score (<em>p</em> = 0.047). Fluid clearance, a component of the Hyodo score, was significantly better in patients with anxiety (<em>p</em> = 0.03) even after propensity score matching adjusted for the effects of age, sex, and fluid clearance.</div></div><div><h3>Conclusion</h3><div><strong>:</strong> In patients with anxiety, swallowing function assessed by FEES was favorable, whereas a higher proportion of patients with depression reported decreased appetite, and lower tongue pressure. This discrepancy between subjective dysphagia and FEES findings suggests that patients with anxiety may underestimate their swallowing function.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 3","pages":"Pages 222-228"},"PeriodicalIF":1.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A small vestibular schwannoma with preoperative facial palsy treated via retrolabyrinthine approach","authors":"Sae Hatomi,&nbsp;Makoto Hosoya,&nbsp;Masafumi Ueno,&nbsp;Marie N Shimanuki,&nbsp;Takanori Nishiyama,&nbsp;Hiroyuki Ozawa,&nbsp;Naoki Oishi","doi":"10.1016/j.anl.2025.03.002","DOIUrl":"10.1016/j.anl.2025.03.002","url":null,"abstract":"<div><div>Facial nerve paralysis caused by a vestibular schwannoma is a rare but critical symptom; however, few reports have focused on preoperative facial nerve palsy from the viewpoint of treatment. In addition, its mechanism is not fully understood. We report a rare case of preoperative facial nerve palsy that improved after the surgical resection of a small vestibular schwannoma with hearing preservation. A small vestibular schwannoma within the internal auditory canal caused acute deafness and facial paralysis in a 51-year-old woman. Conservative treatment was initially administered, but severe hearing loss and facial paralysis persisted for 3 months after onset. Subsequently, we performed tumor resection using the retrolabyrinthine approach. The tumor, which compressed the cochlear and facial nerves, was almost completely removed under continuous intraoperative monitoring to preserve the facial nerve function. “Wait and scan” is generally recommended for vestibular schwannomas within the internal auditory canal. However, this case suggests that early successful surgery, at least in selected cases, can improve paralysis without hearing deterioration and maintain the patient's quality of life.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 3","pages":"Pages 216-221"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"Multi-institutional studies to enhance the understanding of primary salivary gland squamous cell carcinoma\".","authors":"Takumi Kumai, Ryosuke Sato, Miki Takahara","doi":"10.1016/j.anl.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.anl.2025.02.005","url":null,"abstract":"","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558893","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":"Over three-year outcomes of Bonebridge implantation in children and adolescents with congenital bilateral conductive hearing loss","authors":"Yuan Wang,&nbsp;Jikai Zhu,&nbsp;Yujie Liu,&nbsp;Danni Wang,&nbsp;Shouqin Zhao","doi":"10.1016/j.anl.2025.02.007","DOIUrl":"10.1016/j.anl.2025.02.007","url":null,"abstract":"<div><h3>Objective</h3><div>Investigation of the long-term performance and safety of Bonebridge in children and adolescents with congenital bilateral conductive hearing loss (BCHL) over 3 years post-implantation.</div></div><div><h3>Methods</h3><div>20 children and adolescents diagnosed with congenital BCHL underwent Bonebridge implantation over 36 months were enrolled. Preoperative and final follow-up pure-tone average (PTA) results were recorded, and whether postoperative complications occurred. All patients tested under two listening conditions: (1) unaided, (2) Bonebridge aided. The speech reception thresholds (SRTs), speech discrimination scores (SDSs) and sound field hearing thresholds (SFHTs) were measured. The mean absolute error (MAE) of sound source localization was calculated to assess the sound localization accuracy.</div></div><div><h3>Results</h3><div>The median age of 20 patients underwent Bonebridge implantation was 9 years old, and follow-up time was 55 months. There were no difference in PTA air conduction and bone conduction between preoperative with postoperative. The performance in SRTs, SDSs and SFHTs were significantly higher in the Bonebridge aided condition than that in the unaided. Concerning sound source localization, the accuracy of localization exhibited a sharp decline when using a single side Bonebridge. However, their sound localization abilities on the Bonebridge implantation same side remained unaffected. One patient had implant exposure, and completed the experiment with the exposed Bonebridge, then underwent a revision surgery. All other complications were resolved by conservative treatment.</div></div><div><h3>Conclusion</h3><div>The performance and safety of Bonebridge were established in children and adolescents with congenital BCHL over 3 years post-implantation.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 3","pages":"Pages 207-215"},"PeriodicalIF":1.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511095","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":"Multi-institutional studies to enhance the understanding of primary salivary gland squamous cell carcinoma.","authors":"Lazzeroni Matteo, Maniaci Antonino, Lentini Mario, Cristina Amaglio, Capaccio Pasquale","doi":"10.1016/j.anl.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.anl.2025.02.006","url":null,"abstract":"","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506275","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":"A questionnaire survey for an orbital blowout fracture medical examination by Japanese otorhinolaryngologists","authors":"Yasushi Samukawa ,&nbsp;Kosuke Akiyama ,&nbsp;Kosuke Takabayashi ,&nbsp;Hiroshi Hoshikawa","doi":"10.1016/j.anl.2025.02.004","DOIUrl":"10.1016/j.anl.2025.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>The status of orbital blowout fracture (BOF) management remains unclear due to the lack of standardized guidelines and limited data from individual facilities. Therefore, the present study aimed to assess current practices for diagnosing, treating, and evaluating BOF among Japanese otorhinolaryngologists.</div></div><div><h3>Methods</h3><div>A web-based questionnaire was distributed to 1,800 members of the Japanese Rhinologic Society and 621 designated clinical training hospitals. The survey was conducted between May 23 and August 31, 2024, and gathered information on diagnostic procedures, treatment approaches, post-operative evaluations, and complications associated with BOF surgery. Responses from 318 facilities, excluding duplicates, were analyzed.</div></div><div><h3>Results</h3><div>Out of 318 facilities, BOF surgery was performed in 129 by otolaryngologists. Computed tomography (CT) was the primary diagnostic modality used pre-operatively at all facilities, with Hess screen tests also being widely used (82.1 %). However, post-operative CT usage was significantly lower (55.8 %). Surgical indications were often decided within 1–2 weeks post-injury in most facilities. The most common complication was infra-orbital nerve disorder (19.4 %), followed by nasal bleeding (10.1 %) and anterior superior alveolar nerve disorder (9.3 %). An endoscopic endonasal approach was commonly performed for medial wall fractures, while a combined intra-/extra-nasal technique was frequently conducted for inferior wall fractures. Rigid reconstruction was performed on approximately 50 % of cases, using materials such as absorbable plates and autologous bone.</div></div><div><h3>Conclusion</h3><div>The present study highlighted significant variations in BOF management among facilities, indicating the need for standardization in evaluation methods and post-operative follow-up.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 3","pages":"Pages 201-206"},"PeriodicalIF":1.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455135","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":"The long-term stability after regeneration therapy for tympanic membrane perforation","authors":"Masahiro Takahashi,&nbsp;Shin-ichiro Oka,&nbsp;Sakiko Furutate,&nbsp;Syogo Oyamada,&nbsp;Satoshi Iwasaki","doi":"10.1016/j.anl.2025.02.003","DOIUrl":"10.1016/j.anl.2025.02.003","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the long-term stability of regenerative treatment for tympanic membrane perforation (TMP) using gelatin sponge, basic fibroblast growth factor (bFGF) and fibrin glue in a population with TMP closure.</div></div><div><h3>Material and methods</h3><div>Treatment could be performed up to four times until perforation closure was achieved. Cases in which perforation closure was finally achieved underwent 1 year of follow-up observation. Perforation closure rate was assessed more than 1 year after initial perforation closure, cases of reperforation were examined, and complications were considered.</div></div><div><h3>Results</h3><div>Postoperative observation after 1 year showed complete closure of the TM remained in 45 of the 54 cases (83.3 %). A high rate of perforation closure was thus maintained. Apart from five cases with small perforations, no complications such as dizziness, ear discharge, or cholesteatoma formation were observed.</div></div><div><h3>Conclusion</h3><div>These findings suggest the long-term stability of regeneration therapy using gelatin sponge, bFGF, and fibrin glue. This regeneration therapy appears feasible and safe, with a closure rate of TMP after this regeneration therapy equivalent to that of traditional tympanoplasty and myringoplasty.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 2","pages":"Pages 195-199"},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403250","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}