Auris Nasus Larynx最新文献

{"title":"Ultrasonography of the cricoarytenoid joint and its movements","authors":"Chikako Kunieda ,&nbsp;Tomohiro Mori ,&nbsp;Ujimoto Konomi ,&nbsp;Koji Matsushima ,&nbsp;Daigo Komazawa ,&nbsp;Takeharu Kanazawa","doi":"10.1016/j.anl.2024.10.001","DOIUrl":"10.1016/j.anl.2024.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>Ultrasound provides real-time anatomical information and motion. We used ultrasound to image the cricoarytenoid joint and its rotating, rocking, and gliding movements.</div></div><div><h3>Methods</h3><div>Between March and October 2023, 20 patients (10 males and 10 females) who visited our hospital underwent laryngeal ultrasonography. The joint cavity was delineated in four patients (20 %, two males and two females). Conversely, the other patients did not detect it because of acoustic shadows on ultrasonography. We also performed ultrasonography on five volunteers (three males and two females), but only two of them (two females) showed imaging of the joint cavity. Herein, we report the case of a female volunteer in her 30 s who had the best delineation of joint movements.</div></div><div><h3>Results</h3><div>Joint movements were three-dimensional, whereas ultrasound images were two-dimensional. However, combined with scanning techniques, characteristic joint movements were successfully imaged using ultrasound. Initially, we performed a trans-thyroid cartilage transversal procedure to visualize the muscular process of the arytenoid cartilage and rotational movement. Subsequently, the probe was rotated to an oblique position, and the articular cavity of the cricoarytenoid joint was visualized. We then observed the rocking and gliding movements. In Addition, we demonstrated a seamless transition from gliding to rocking. Finally, we observed that the arytenoid cartilage was pulled toward the posterior cricoarytenoid muscle (PCA) during sniffing. The PCA is the only muscle opening the vocal cords, so the arytenoid cartilage shifts toward the PCA and tilts outward from the larynx.</div></div><div><h3>Conclusion</h3><div>The presented probe scanning techniques and specific joint movements may help identify notable conditions such as arthritis or joint dislocation.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1068-1072"},"PeriodicalIF":1.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593221","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":"Efficacy of 1.5% levofloxacin otic solution in treating acute otitis externa: A post hoc analysis of ENT103-3001, a multicenter randomized double-blind parallel-group placebo-controlled phase III study in otitis media with persistent otorrhea","authors":"Han Matsuda ,&nbsp;Masafumi Sawada ,&nbsp;Kayo Suzuki ,&nbsp;Haruo Takahashi ,&nbsp;Tetsuo Ikezono","doi":"10.1016/j.anl.2024.10.015","DOIUrl":"10.1016/j.anl.2024.10.015","url":null,"abstract":"<div><h3>Objective</h3><div>In this post hoc analysis, we aimed to evaluate the efficacy of 1.5% levofloxacin (LVFX) otic solution for the treatment of acute otitis externa (AOE) in patients with nonintact tympanic membrane (NTM) accompanied by chronic suppurative and acute otitis media.</div></div><div><h3>Methods</h3><div>Digital endoscopic images of the tympanic membrane and cavity were evaluated. In addition, the full analysis set from the original ENT103-3001 study was analyzed to determine the efficacy of the 1.5% LVFX otic solution in treating patients with otitis media with persistent otorrhea. AOE was diagnosed by a study-specific blinded independent review committee (BIRC) in the present study, which reviewed the presence of inflammatory findings, such as edema, erosion, and/or erythema (redness), in the external ear canal on the digital endoscopic images acquired at screening. The improvement in the inflammatory findings in each diseased ear was evaluated by examining the digital endoscopic images acquired at the end of treatment (EOT; including study discontinuation) and follow-up (F/U) visits. Data regarding residual purulent otorrhea at EOT and F/U visits were assessed by the BIRC of the ENT103-3001 study. Similarly, otological symptoms at EOT were recorded in the patients’ diaries, and the bacterial eradication rates were used from the ENT103-3001 study. Improvement was defined as the resolution of the inflammatory findings and purulent otorrhea.</div></div><div><h3>Results</h3><div>Among the 201 patients with otitis media, 161 patients had AOE (LVFX group, 82; placebo group, 79). The difference (95% confidence interval) between the groups at EOT was 27.3% (12.7, 40.3), and the proportion of patients showing improvement in all inflammatory findings in the external ear canal in the LVFX group (47.6%, 39/82) was significantly higher than that in the placebo group (20.3%, 16/79; Fisher's exact test, <em>p</em> &lt; 0.001). Similarly, the bacterial eradication rate in the LVFX group (94.3%, 66/70) was also significantly higher than that in the placebo group (10.3%, 7/68; Fisher's exact test, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The use of 1.5% LVFX otic solution resulted in a significantly higher rate of improvement in inflammatory findings in the external ear canal and bacterial eradication rate, indicating its efficacy. Thus, 1.5% LVFX otic solution may be an effective treatment for chronic suppurative otitis media and acute otitis media, as well as AOE with NTM.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1060-1067"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549157","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 narrative review of basic and clinical studies for vocal fold regeneration therapies","authors":"Cathrine Miura ,&nbsp;Rumi Ueha ,&nbsp;Maria Angela Dealino ,&nbsp;Naoyuki Matsumoto ,&nbsp;Taku Sato ,&nbsp;Takao Goto ,&nbsp;Kenji Kondo","doi":"10.1016/j.anl.2024.10.011","DOIUrl":"10.1016/j.anl.2024.10.011","url":null,"abstract":"<div><h3>Objective</h3><div>To review the various basic research and treatments available to regenerate the vocal folds and to discuss the direction for future treatments.</div></div><div><h3>Methods</h3><div>A comprehensive review was performed in PubMed database and Google Scholar utilizing search terms including combinations and variations of the following concepts: vocal fold anatomy, vocal fold disorders, and regenerative therapies. No particular inclusion or exclusion criteria were set due to the nature of this narrative review article.</div></div><div><h3>Results/Discussion</h3><div>The regenerative treatments available for each vocal fold layer are the following: 1) epidermal growth factor and transforming growth factor-β1 for the epithelial layer, 2) autologous fibroblasts, autologous bone-marrow derived mesenchymal stem cells (MSCs), autologous adipose tissue-derived stromal vascular fraction (ADSVF), basic fibroblast growth factor (bFGF), collagen-hyaluronic acid nanofiber, pirfenidone, hepatocyte growth factor (HGF), pulsed dye laser (PDL), diode laser, and platelet-rich plasma (PRP) for the lamina propria, 3) bFGF and controlled-release bFGF with autologous fascia, HGF, c-Met agonistic antibody, and PRP for the muscular layer, 4) and bFGF and PRP-loaded nerve guidance conduit for the nerve. Treatments deemed clinically safe with sustained efficacy assessed up to 6 months are HGF and PDL, while bFGF, autologous fibroblasts, autologous bone marrow-derived MSCs, ADSVF, and PRP have been studied up to 12 months.</div></div><div><h3>Conclusion</h3><div>An ideal regenerative treatment is one that restores the injured or lost components of the vocal fold. The layered structure of the vocal fold allows for several mechanisms of action for these regenerative therapies. Further experimental and clinical studies are warranted, and these would dictate the impact of vocal fold regenerative therapies. Regenerative medicine may soon be at the forefront for treating vocal fold disorders. Clinicians should be open to advancements in treatment and consider the potential of novel therapies to treat specific pathologies.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1052-1059"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549156","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":"Evaluation of the preventive effect of sublingual immunotherapy for pediatric bronchial asthma","authors":"Takanari Kawabe ,&nbsp;Kayoko Kawashima ,&nbsp;Yuko Nagai ,&nbsp;Mika Okuno ,&nbsp;Yukiko Hanada ,&nbsp;Tomohiro Yamaguchi ,&nbsp;Rumi Ueno ,&nbsp;Yuki Tsurinaga ,&nbsp;Youhei Fukasawa ,&nbsp;Yuri Takaoka ,&nbsp;Yukinori Yoshida ,&nbsp;Makoto Kameda","doi":"10.1016/j.anl.2024.10.008","DOIUrl":"10.1016/j.anl.2024.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine the effectiveness of sublingual immunotherapy (SLIT) in preventing the exacerbation of asthma.</div></div><div><h3>Methods</h3><div>This retrospective study investigated the changes in the rate of continuous steroid inhalation introduced over three years due to SLIT in 328 patients aged 5–15 years who were diagnosed with allergic rhinitis between January 1, 2018, and December 31, 2019. These patients were not initially prescribed with continuous steroid inhalation. SLIT and symptomatic treatment groups were compared over 3 years using chi-square and Fisher's exact tests, controlling for age with multiple regression analysis. The SLIT subgroups and factors contributing to asthma exacerbation were examined as secondary endpoints.</div></div><div><h3>Results</h3><div>The study comprised 151 patients in the SLIT group and 177 patients in the symptomatic treatment group, with higher average age and IgE levels in the SLIT group. High continuation rates for SLIT were observed over 3 years. Asthma exacerbation within 3 years was notably lower in the SLIT group, particularly in the cedar-only and combined SLIT groups. Multiple regression analysis confirmed the duration of SLIT as a significant factor in preventing asthma exacerbation. Additionally, Fisher's exact test supported these findings.</div></div><div><h3>Conclusion</h3><div>This study demonstrated the effectiveness of SLIT in reducing the exacerbation of asthma in children with allergic rhinitis. SLIT was associated with lower rates of asthma exacerbation over a three-year period compared to symptomatic treatment.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1031-1036"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549158","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":"Percutaneous laryngeal elevation technique to achieve excellent hypopharyngeal exposure in transoral surgery","authors":"Satoshi Koyama,&nbsp;Toru Kimura,&nbsp;Ryohei Donishi,&nbsp;Kenkichiro Taira,&nbsp;Takahiro Fukuhara,&nbsp;Kazunori Fujiwara","doi":"10.1016/j.anl.2024.10.014","DOIUrl":"10.1016/j.anl.2024.10.014","url":null,"abstract":"<div><div>Endoscopic laryngopharyngeal surgery (ELPS) is a transoral surgery performed for the treatment of early-stage pharyngeal and supralaryngeal cancer. In Japan, ELPS is often chosen for transoral resection of hypopharyngeal cancer. However, in cases of trismus, exposing the hypopharynx even with ELPS using a curved laryngoscope may not be possible. Thus, we developed the percutaneous laryngeal elevation technique (PLET). The PLET is easy to perform because it only requires the addition of a percutaneous suture on the larynx and lifting the larynx ventrally. The PLET could dramatically improve hypopharynx exposure and allow us to perform ELPS on a patient with hypopharyngeal cancer experiencing severe trismus. A 64-year-old man was referred to our hospital for the treatment of hypopharyngeal cancer (cTisN0M0). He had severe trismus because of past surgery and radiotherapy for buccal mucosa cancer. Mouth-opening surgery was performed initially, followed by ELPS. However, the hypopharynx was insufficiently exposed, and the entire tumor could not be visualized. The PLET was performed, which dramatically improved the exposure and allowed us to resect the tumor with sufficient surgical margin. In this case, no intra- and postoperative PLET-related complications were observed. Thus, the PLET is an easy and safe technique for improving hypopharyngeal exposure.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1048-1051"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549159","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":"Effects of multilevel OSA surgery on patients with poor cardiopulmonary performance: A prospective pilot study","authors":"Chung-Wei Lin ,&nbsp;Pei-Wen Lin ,&nbsp;Li-Wen Chiu ,&nbsp;Mao-Chang Su ,&nbsp;Han-Tan Chai ,&nbsp;Chun-Tuan Chang ,&nbsp;Michael Friedman ,&nbsp;Anna M. Salapatas ,&nbsp;Hsin-Ching Lin","doi":"10.1016/j.anl.2024.10.005","DOIUrl":"10.1016/j.anl.2024.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>Multilevel airway surgery for obstructive sleep apnea/hypopnea syndrome (OSA) has benefits in improving sleep quality, but its effect on polysomnography (PSG) and 6-minute walk test (6MWT) parameters, including walking distance and cardiopulmonary performance, in patients with poor pre-operative cardiopulmonary performance remains understudied, which should be further investigated.</div></div><div><h3>Methods</h3><div>This prospective pilot study enrolled 27 consecutive OSA patients with poor pre-operative 6MWT results. All patients received multilevel OSA surgery, and the alterations of sleep parameters and 6MWT profiles were studied. The pre- and post-operative values of polysomnographic data and 6MWT profiles were analyzed using the <em>Wilcoxon signed-rank tests</em>. The relationships among changes of the indices of PSG and 6MWT were further investigated with the <em>Spearman's correlations</em>.</div></div><div><h3>Results</h3><div>After surgery, the sleep parameters and certain cardiopulmonary indices improved. When analyzing the correlations among changes of the indices of PSG and 6MWT, the improvement of daytime sleepiness (with ESS) was found related to farther walking distance (ρ=-0.414, <em>p</em> = 0.032) and higher percentage of “distance/target distance” (ρ=-0.435, <em>p</em> = 0.023). Moreover, the change of maximal expiratory pressure was the only index associated with the changes of AHI (apnea/hypopnea index, /hr.; ρ=-0.407, <em>p</em> = 0.035) and AHI in REM (ρ=-0.502, <em>p</em> = 0.009) among the cardiopulmonary performance parameters.</div></div><div><h3>Conclusion</h3><div>This pilot study showed that OSA patients with poor pre-operative cardiopulmonary status undergoing multilevel sleep surgery could experience improvement in the sleep study and 6MWT to some extent. The relatively better walking distance and cardiopulmonary performance after the operation might potentially result from the improvement of daytime sleepiness and better respiration.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1042-1047"},"PeriodicalIF":1.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523744","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 hearing loss and Glasgow prognostic score in patients with cancer","authors":"Shin Matsumoto ,&nbsp;Yuki Hirose ,&nbsp;Ryota Ishii ,&nbsp;Masahiro Nakayama ,&nbsp;Kazuki Takahashi ,&nbsp;Kento Sasaki ,&nbsp;Keitaro Fujii ,&nbsp;Keiji Tabuchi","doi":"10.1016/j.anl.2024.10.009","DOIUrl":"10.1016/j.anl.2024.10.009","url":null,"abstract":"<div><h3>Objective</h3><div>Oxidative stress damages cochlear hair cells <em>in vitro</em>. However, the effect of systemic inflammation on hearing loss remains unclear. Growing evidence suggests that malnutrition influences the development of hearing loss. In this study, we aimed to investigate the influence of the Glasgow prognostic score (GPS), which is calculated based on systemic inflammatory responses and malnutrition, on auditory threshold increases in patients with cancer.</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study included patients with cancer who underwent standard pure-tone audiometry (PTA) between November 2014 and May 2023. Patients with complete data in their electronic medical records within 90 days before undergoing standard PTA were included. Multivariate analysis was performed using auditory threshold as the response variable. Covariates, including GPS, were obtained from blood data and physical data before standard PTA. The GPS was classified into three levels based on serum albumin and C-reactive protein levels.</div></div><div><h3>Results</h3><div>Standard PTA was performed 14,868 times in 5,462 patients. Of these, 742 had cancer and 384 met the inclusion criteria. Multivariate analysis revealed that older age, creatinine clearance &lt;60 mL/min, and high GPS significantly increased the auditory threshold at frequencies of 500–8,000 Hz. A history of platinum drug use and male sex increased the auditory threshold at frequencies &gt;4,000 and &gt;2,000 Hz, respectively.</div></div><div><h3>Conclusion</h3><div>The GPS was independently associated with elevated standard PTA thresholds in patients with cancer. These results suggest an association between malnutrition/chronic inflammation and hearing loss and provide new information for planning clinical research on hearing loss prevention.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1037-1041"},"PeriodicalIF":1.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530968","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 retrospective analysis of syphilis cases with a focus on otolaryngology at a university hospital","authors":"Hiroaki Iijima ,&nbsp;Akihiro Sakai ,&nbsp;Koji Ebisumoto ,&nbsp;Mayu Yamauchi ,&nbsp;Daisuke Maki ,&nbsp;Takanobu Teramura ,&nbsp;Kosuke Saito ,&nbsp;Aritomo Yamazaki ,&nbsp;Toshihide Inagi ,&nbsp;Ai Yamamoto ,&nbsp;Hiroshi Ashida ,&nbsp;Yurina Sato ,&nbsp;Shota Sato ,&nbsp;Kenji Okami","doi":"10.1016/j.anl.2024.09.009","DOIUrl":"10.1016/j.anl.2024.09.009","url":null,"abstract":"<div><h3>Objectives</h3><div>In recent years, there has been a notable increase in syphilis cases in Japan and Western countries. Syphilis, a classic sexually transmitted disease caused by treponemas, presents diagnostic challenges due to its diverse clinical manifestations. This study explores the diagnosis of syphilis in patients treated at our hospital.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients who visited our hospital between April 2015 and March 2024. The review focused on the patients' clinical backgrounds, onset times, symptoms, diagnostic processes, and clinical courses.</div></div><div><h3>Results</h3><div>Our hospital had 45 cases of syphilis. Forty-five cases of syphilis were diagnosed as syphilis in our hospital (13 cases were diagnosed in the Otolaryngology: ENT department). The median age was 40 years, with a significant male predominance (male-to-female ratio of 34:11). The median duration from the onset of subjective symptoms to syphilis diagnosis was 54 days. The timeframe from the initial clinic visit to diagnosis ranged from 1 to 57 days, with a median of nine days. Notably, 47.5% of the patients reported a history of employment or patronage in the sex industry. 73.3% of patients presented to local clinics with any kind of subjective symptoms, but syphilis was often missed in the differential diagnosis. Patients visiting the ENT department were referred to our hospital with a diagnosis of persistent oral ulcer, oropharyngeal carcinoma and neck lymphadenopathy. Histological and cytological evaluation was performed in 33% of patients, but the diagnosis was often difficult to make. Additionally, some patients initially denied using sex services at their first visit but later disclosed this during subsequent visits to the Department of Infectious Diseases, highlighting the critical role of thorough medical history assessments.</div></div><div><h3>Conclusion</h3><div>Diagnosing syphilis can be challenging unless the physician specifically suspects it. It is crucial to consider syphilis in cases of pharyngeal mucosal inflammation and neck lymphadenopathy. This study highlights the need for heightened awareness and education regarding the signs and symptoms of syphilis, particularly oropharyngeal and skin findings, to ensure timely diagnosis and treatment.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1016-1024"},"PeriodicalIF":1.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513517","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":"Effectiveness of CI as an alternative to ABI for hearing loss in patients with vestibular schwannomas: A multicenter study in Japan","authors":"Mitsuyoshi Imaizumi ,&nbsp;Hidehiko Takeda ,&nbsp;Shujiro Minami ,&nbsp;Naoki Oishi ,&nbsp;Daisuke Yamauchi ,&nbsp;Shigeyuki Murono ,&nbsp;Hirofumi Nakatomi ,&nbsp;Kiyoshi Saito ,&nbsp;Akio Morita ,&nbsp;Masazumi Fujii","doi":"10.1016/j.anl.2024.10.010","DOIUrl":"10.1016/j.anl.2024.10.010","url":null,"abstract":"<div><h3>Objective</h3><div>NF2-related schwannomatosis (NF2) is characterized by bilateral vestibular schwannomas (VS), often causing severe damage to the bilateral auditory function. Auditory brainstem implantation (ABI) provides hearing-impaired patients with an opportunity to reacquire auditory sensation through electrical stimulation of auditory neurons in the cochlear nucleus. However, ABI is not covered by public health insurance in Japan, leading to a large difference in financial burden compared to cochlear implantation (CI). The aim of the present study was to demonstrate the effectiveness of CI as an alternative to ABI for hearing reacquisition in patients with profound hearing loss caused by VS.</div></div><div><h3>Methods</h3><div>To investigate the current situation of ABI and CI for hearing reconstruction in VS patients, we conducted a questionnaire survey of 102 facilities in Japan. Based on the responses to the questionnaire, a multicenter research group consisting of otolaryngologists and neurosurgeons was established. We collected detailed data on patients with VS who underwent ABI (<em>n</em> = 7, all NF2) and CI (<em>n</em> = 14 [nine NF2, and five non-NF2]).</div></div><div><h3>Results</h3><div>Some sense of hearing was obtained in all patients but one with CI indicating the efficacy of CI and ABI for profound hearing loss caused by VS. The mean hearing levels were 45.4 dB HL in the ABI patients and 32.7 dB HL in the CI patients, indicating that CI was effective as an alternative to ABI.</div></div><div><h3>Conclusion</h3><div>The results of the present study suggest the effectiveness of CI as an alternative to ABI for hearing reacquisition in patients with profound hearing loss caused by VS.</div></div><div><h3>Level of evidence</h3><div>4.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1009-1015"},"PeriodicalIF":1.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513519","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":"Combination therapy with BRAF and MEK inhibitors for anaplastic thyroid cancer: A report of two cases","authors":"Mayu Yamauchi,&nbsp;Akihiro Sakai,&nbsp;Koji Ebisumoto,&nbsp;Hiroaki Iijima,&nbsp;Takanobu Teramura,&nbsp;Aritomo Yamazaki,&nbsp;Ryoko Yanagiya,&nbsp;Ai Yamamoto,&nbsp;Yoshiyuki Ota,&nbsp;Hiroshi Ashida,&nbsp;Naoya Kobayashi,&nbsp;Kenji Okami","doi":"10.1016/j.anl.2024.10.002","DOIUrl":"10.1016/j.anl.2024.10.002","url":null,"abstract":"<div><div>Anaplastic thyroid cancer (ATC) is an aggressive malignancy with a poor prognosis and limited treatment options. Herein, we report two cases of unresectable ATC treated with a combination of BRAF and MEK inhibitors. The patients were initially treated with other therapies but were switched to BRAF and MEK inhibitors after testing positive for <em>BRAF</em> mutations. This resulted in a partial response, tumor shrinkage, and conversion to resectability in one case. The patient experienced manageable adverse events. <em>BRAF</em> mutations are common in thyroid cancers, and studies have demonstrated the efficacy of combining BRAF and MEK inhibitors for treating advanced or recurrent differentiated thyroid cancer or ATC with <em>BRAF</em> mutations. These cases emphasize the importance of <em>BRAF</em> gene testing at the initial diagnosis and the potential of BRAF and MEK inhibitors as treatment options for unresectable ATC with <em>BRAF</em> mutations. The oral administration and manageable adverse event profiles of these medications make them suitable for outpatient treatment. In conclusion, <em>BRAF</em> gene testing should be performed at the initial diagnosis, and the use of BRAF and MEK inhibitors should be considered in patients with ATC.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 1003-1008"},"PeriodicalIF":1.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513518","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}