Auris Nasus Larynx最新文献

{"title":"Can Hounsfield unit density value accurately predict prelaryngeal invasion in laryngeal carcinoma cases","authors":"Senem Kurt Dizdar ,&nbsp;Egehan Salepci ,&nbsp;Burçin Ağrıdağ ,&nbsp;Nurullah Seyhun ,&nbsp;Ali Gemalmaz ,&nbsp;Suat Turgut","doi":"10.1016/j.anl.2024.06.003","DOIUrl":"10.1016/j.anl.2024.06.003","url":null,"abstract":"<div><h3>Objective</h3><p>The Hounsfield unit density value (HUDV) is a relative quantitative measurement of radio density used by radiologists in the interpretation of computed tomography (CT) images. Our aim is to investigate the role of HUDV in evaluating pre-epiglottic space (PES) involvement of laryngeal carcinoma.</p></div><div><h3>Methods</h3><p>Seventy-four patients treated for laryngeal carcinoma in our clinic between 2014 and 2019 were included in the study. The invasion status of PES was determined radiologically and pathologically. HUDV was measured with a circular selected region of interest, with a constant size of 10 mm² for PES. The relationship between patological PES invasion, radiological PES invasion, and HUDV was evaluated.</p></div><div><h3>Results</h3><p>Measuring HUDV to determine PES invasion (74.3 %) was significantly higher than​​ conventional CT evaluation (59.5 %) (<em>p</em> = 0.001). The agreement coefficient (kappa value) of the conventional CT evaluation and the HUDV regarding PES involvement was 0.673, which was interpreted as ‘good’.</p></div><div><h3>Conclusion</h3><p>HUDV could be used as an additional tool in diagnosing pre-epiglottic space invasion in laryngeal cancer.</p></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 4","pages":"Pages 803-810"},"PeriodicalIF":1.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536041","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":"Intractable epistaxis requiring surgical exploration or arterial embolization; Associated comorbidities and locations of the bleeder","authors":"Hong-kwon Kil,&nbsp;Jae-Cheul Ahn","doi":"10.1016/j.anl.2024.06.001","DOIUrl":"10.1016/j.anl.2024.06.001","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to determine which comorbidities were associated with intractable epistaxis requiring electrocauterization or embolization, and to identify the location where intractable epistaxis frequently occurred.</p></div><div><h3>Methods</h3><p>The patients were divided into two groups: patients with epistaxis successfully controlled in outpatient department (OPD) and those with intractable epistaxis in OPD which was controlled by surgical exploration or arterial embolization (OP/EM). Evaluations of the bleeding locations, related vessels, and patient's comorbidities were conducted.</p></div><div><h3>Results</h3><p>A total of 41 patients from the OP/EM group and 725 patients from the OPD group were enrolled. The following comorbidities showed elevated risks of the intractable epistaxis (<em>p</em>&lt; 0.05) in multivariate analysis; hypertension (OR 1.089, 95% CI 1.049 - 1.132), dyslipidemia (1.132, 1.041 - 1.232), liver cirrhosis (1.272, 1.152 - 1.406), chronic obstructive pulmonary disease (1.234, 1.078 - 1.412) and asthma (1.205, 1.053 - 1.379). Inferior and middle turbinate were equally the most common location of the intractable bleeding.</p></div><div><h3>Conclusion</h3><p>In patients with epistaxis requiring hemostatic treatments, comorbidities such as hypertension, dyslipidemia, liver diseases, COPD, and asthma were associated with intractable epistaxis. The main bleeding sites of intractable epistaxis were the middle and inferior turbinate.</p></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 4","pages":"Pages 797-802"},"PeriodicalIF":1.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536042","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":"Boron neutron capture therapy as a larynx-preserving treatment for locally recurrent laryngeal carcinoma after conventional radiation therapy: A preliminary report","authors":"Masaaki Higashino ,&nbsp;Teruhito Aihara ,&nbsp;Satoshi Takeno ,&nbsp;Hu Naonori ,&nbsp;Tsuyoshi Jinnin ,&nbsp;Keiji Nihei ,&nbsp;Koji Ono ,&nbsp;Ryo Kawata","doi":"10.1016/j.anl.2024.06.007","DOIUrl":"10.1016/j.anl.2024.06.007","url":null,"abstract":"<div><h3>Objective</h3><p>Laryngeal preservation and a radical cure are the treatment goals for laryngeal carcinoma, and larynx-preserving therapy is generally preferred for early-stage laryngeal carcinoma. When laryngeal carcinoma recurs locally, patients are often forced to undergo total laryngectomy, resulting in loss of vocal function. However, many patients with laryngeal carcinoma who have residual or recurrent disease after radiotherapy wish to preserve their voice. The purpose of this study was to investigate the possibility of using BNCT as a larynx-preserving treatment for residual or recurrent laryngeal carcinomas following radical irradiation.</p></div><div><h3>Patients and Methods</h3><p>This study included 15 patients who underwent BNCT for residual or recurrent laryngeal carcinoma after radical laryngeal carcinoma irradiation. The number of treatment sessions for all patients was one irradiation. Before BNCT, the recurrent laryngeal carcinoma stage was rT1aN0, rT2N0, rT2N1, rT3N0, rT3N1, and rT4aN0 in one, six, one, three, one, and three patients, respectively. The median maximum tumor diameter before BNCT was 15 mm (8–22 mm). All patients underwent a tracheostomy before BNCT to mitigate the risk of upper airway stenosis due to laryngeal edema after BNCT. Treatment efficacy was evaluated retrospectively using monthly laryngoscopy after BNCT and contrast-enhanced CT scans at 3 months. The safety of treatment was evaluated based on examination findings and interviews with patients.</p></div><div><h3>Results</h3><p>The median hospital stay after BNCT was 2 days (1–6). The response rate at three months after BNCT in 15 patients with locally recurrent laryngeal carcinoma was 93.3 %, and the CR rate was 73.3 %. The most frequent adverse event associated with BNCT was laryngeal edema, which occurred in nine patients the day after BNCT. The average course of laryngeal edema peaked on the second day after BNCT and almost recovered after 1 week in all patients. One patient had bilateral vocal fold movement disorders. None had dyspnea because of prophylactic tracheostomy. No grade four or higher adverse events occurred. Other grade 2 adverse events included pharyngeal mucositis, diarrhea, and sore throat. Three months after BNCT, tracheostomy tubes were removed in nine patients, retinal cannulas were placed in three patients, and voice cannulas were placed in three patients.</p></div><div><h3>Conclusions</h3><p>BNCT for locally recurrent laryngeal carcinoma can safely deliver radical irradiation to tumor tissues, even in patients undergoing radical irradiation. BNCT has shown antitumor effects against recurrent laryngeal carcinoma. However, further long-term observations of the treatment outcomes are required.</p></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 4","pages":"Pages 792-796"},"PeriodicalIF":1.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536040","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":"Factors influencing residual plus moist HS-W calcium alginate packing material after endoscopic sinus surgery","authors":"Kazuhiro Nomura ,&nbsp;Tomotaka Hemmi ,&nbsp;Mitsuru Sugawara ,&nbsp;Ryoukichi Ikeda","doi":"10.1016/j.anl.2024.06.005","DOIUrl":"10.1016/j.anl.2024.06.005","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to evaluate the presence of residual Plus Moist HS-W (PM), a novel calcium alginate packing material, during the initial postoperative visit following endoscopic sinus surgery. The research aims to identify factors that influence the quantity of remaining PM.</p></div><div><h3>Methods</h3><p>A retrospective review of medical records was conducted for patients who underwent middle meatus packing with PM.</p></div><div><h3>Results</h3><p>A total of fifty-two patients (representing 92 sides of paranasal sinuses) were included in the analysis. The remaining PM was classified as follows: absent (0) in 41 out of 92 cases, minimal (1) in 22 out of 92 cases, moderate (2) in 15 out of 92 cases, and substantial (3) in 14 out of 92 cases. Notably, all three patients who underwent Draf III surgery exhibited a significant amount of PM during their initial visit, with two patients classified as grade 2 and one patient as grade 3. Other factors investigated were found to be unrelated to the persistence of PM. Removal of all PM was achieved effortlessly using suction under flexible endoscopy.</p></div><div><h3>Conclusion</h3><p>This study highlights the efficacy of PM in post-endoscopic sinus surgery care. It is important to limit an amount of PM, particularly in Draf III procedures.</p></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 4","pages":"Pages 779-782"},"PeriodicalIF":1.6,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473006","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":"Concordance in bacterial colonization profiles between voice prostheses and oral microbiota post-laryngectomy: An experimental study","authors":"Salvatore Cocuzza ,&nbsp;Antonino Maniaci ,&nbsp;Ignazio La Mantia ,&nbsp;Federica Maria Parisi ,&nbsp;Jerome Lechien ,&nbsp;Miguel Mayo-Yanez ,&nbsp;Maddalena Calvo ,&nbsp;Tareck Ayad ,&nbsp;Mario Lentini ,&nbsp;Salvatore Lavalle ,&nbsp;Nicolas Fakhry ,&nbsp;Laura Trovato","doi":"10.1016/j.anl.2024.06.006","DOIUrl":"10.1016/j.anl.2024.06.006","url":null,"abstract":"<div><h3>Objective</h3><p>Knowledge about voice prosthesis microbial colonization is vital in laryngectomized patients’ quality of life (QoL). Herein, we aimed to explore the relationship between oral microbial patterns, demographic variables and voice prosthesis performance.</p></div><div><h3>Methods</h3><p>Thirty laryngectomy patients were assessed for microbial colonization in their voice prostheses and oral cavities. Factors like age, proton pump inhibitor (PPI) usage, and alcohol consumption were considered.</p></div><div><h3>Results</h3><p>Participants' average age was 74.20 ± 7.31 years, with a majority on PPIs. <em>Staphylococcus aureus</em> was the most common bacterium in prostheses (53 %), followed by <em>Pseudomonas aeruginosa</em> (27 %). <em>Candida albicans</em> was the primary fungal colonizer (67 %). A statistically significant moderate correlation was found between fungal species before and after oral rinsing (<em>p</em> = 0.035, Phi=0.588, Cramer's <em>V</em> = 0.416). Voice prosthesis and oral cavity microbiota profiles showed significant concordance (kappa=0.315, <em>p</em> &lt; 0.004). Among subgroup analyses, bacterial patterns of colonization did not significantly influence VHI (<em>p</em> = 0.9555), VrQoL (<em>p</em> = 0.6610), or SF-36 (<em>p</em> = 0.509) scores. Conversely, fungal patterns of VP colonization significantly impacted subjective voice scores, with <em>Candida krusei</em> demonstrating better VHI (35.25 ± 3.63 vs. 44.54 ± 6.33; <em>p</em> = 0.008), VrQoL (7.13 ± 1.69 vs. 10.73 ± 2.00; <em>p</em> = 0.001), and SF-36 (69.36 ± 7.09 vs. 76.50 ± 7.73; <em>p</em> = 0.051) scores compared to <em>C. albicans</em>.</p></div><div><h3>Conclusions</h3><p>There was a significant correlation between the oral microbiota and voice prosthesis colonization. These insights can inform improved care strategies for voice prostheses, enhancing patient outcomes.</p></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 4","pages":"Pages 783-791"},"PeriodicalIF":1.6,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473005","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":"Guidance of clinical management for patients with tonsillar focal disease","authors":"Miki Takahara ,&nbsp;Akira Doi ,&nbsp;Ayako Inoshita ,&nbsp;Junichiro Ohori ,&nbsp;Masamitsu Kono ,&nbsp;Ai Hirano ,&nbsp;Takuya Kakuki ,&nbsp;Kentaro Yamada ,&nbsp;Hirofumi Akagi ,&nbsp;Kenichi Takano ,&nbsp;Seiichi Nakata ,&nbsp;Yasuaki Harabuchi","doi":"10.1016/j.anl.2024.05.010","DOIUrl":"10.1016/j.anl.2024.05.010","url":null,"abstract":"<div><p>Tonsillar focal diseases (TFDs) are defined as “diseases caused by organic and/or functional damage in organs distant from tonsil, and the disease outcome is improved by tonsillectomy.” Although several reports and reviews have shown the efficacy of tonsillectomy for TFDs, no guidelines for the clinical management of the diagnosis and treatment of TFDs have been reported. Therefore, the Society of Stomato-pharyngology established a committee to guide the clinical management of patients with TFDs, and the original guide was published in May 2023. This article summarizes the English version of the manuscript. We hope that the concept of TFDs will spread worldwide, and that one as many patients with TFDs will benefit from tonsillectomy.</p></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 4","pages":"Pages 761-773"},"PeriodicalIF":1.7,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0385814624000695/pdfft?md5=104f211f27d60e2d01ee7df2db51cc03&pid=1-s2.0-S0385814624000695-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141322124","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":"Modified method for tracheoesophageal fistula closure in intractable cases","authors":"Atsushi Suehiro,&nbsp;Keigo Honda,&nbsp;Yo Kishimoto,&nbsp;Ken Iwanaga,&nbsp;Shintaro Fujimura,&nbsp;Yoshitaka Kawai,&nbsp;Tsuyoshi Kojima,&nbsp;Kiyomi Hamaguchi,&nbsp;Koichi Omori","doi":"10.1016/j.anl.2024.06.002","DOIUrl":"10.1016/j.anl.2024.06.002","url":null,"abstract":"<div><h3>Objective</h3><p>Tracheoesophageal puncture (TEP) is one of the most established methods for voice reacquisition following total laryngectomy. The most difficult complication following TEP is the management of saliva leakage or secretion into the trachea due to TE fistula enlargement. In this study, we devised a new strategy to close TE fistulas and confirmed its safety and effectiveness.</p></div><div><h3>Methods</h3><p>Skin incision: If the tracheal mucosa around the voice prosthesis appears intact and normal, an arcuate incision, from 10 to 2 o'clock, is made on the skin 5 mm superior to the edge of the stoma. However, if the surrounding tracheal mucosa is fragile because of leaking, the incision is made on the superior edge of the stoma, with later reconstruction of the posterior tracheal wall. Separation of the trachea and esophagus: If the esophagotracheal spatium appears normal and is easy to dissect, the connective pipes can be found easily. After cutting the pipe, a ligature alone is sufficient for the tracheal side; however, the esophageal wall is closed with Gambee sutures. If the esophagotracheal spatium is compromised and the posterior tracheal wall is fragile (due to saliva leakage), we remove the posterior wall and reconstruct the area using the superior skin flap. We performed our novel method on four patients with intractable conditions; postradiotherapy for laryngeal cancer, total pharyngo-laryngo-esophagectomy (TPLE) with jejunum reconstruction, TPLE with gastric lifting reconstruction, and in a patient who underwent cervicothoracic incisional drainage for descending necrotizing mediastinitis.</p></div><div><h3>Results</h3><p>None of the cases showed postoperative leakage from the fistula, and oral intake was resumed without difficulty.</p></div><div><h3>Conclusion</h3><p>This study showed that this strategy based on TE fistula conditions is effective even in difficult-to-treat cases.</p></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 4","pages":"Pages 774-778"},"PeriodicalIF":1.7,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141322125","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":"Differential expression of epidermal growth factor receptor in various pathological types of salivary gland cancers","authors":"Hajime Fujiwara ,&nbsp;Yoshinori Kodama ,&nbsp;Hikari Shimoda ,&nbsp;Masanori Teshima ,&nbsp;Hirotaka Shinomiya ,&nbsp;Ken-ichi Nibu","doi":"10.1016/j.anl.2024.05.007","DOIUrl":"https://doi.org/10.1016/j.anl.2024.05.007","url":null,"abstract":"<div><h3>Objective</h3><p>While several studies reported epidermal growth factor receptor (EGFR) expression in salivary gland cancer (SGC), results varied due to a lack of unified definition of EGFR positivity. In this study, we assessed the EGFR expression level using both EGFR positive score and cumulative EGFR score in the patients with SGC.</p></div><div><h3>Methods</h3><p>Between January 2010 and April 2021, 102 patients with SGC who underwent surgical resection were reviewed retrospectively by immunohistochemistry. The membrane staining intensity was scored as follows: no staining (0), weak staining (1+), intermediate staining (2+), and strong staining (3+). The cumulative EGFR score was determined on a continuous scale of 0–300 using the formula:1 × (1+: percentage of weakly stained cells) + 2 × (2+: percentage of moderately stained cells) + 3 × (3+: percentage of strongly stained cells).</p></div><div><h3>Results</h3><p>EGFR expression in SGC varied widely even among the same as well as different histopathological types. The average EGFR positive scores were 46.0 %, 55.7 %, 51.6 %, 1.0 %, 26.8 %, 50 %, and 76.8 % for mucoepidermoid carcinoma (MEC), salivary duct carcinoma (SDC), adenoid cystic carcinoma (AdCC), acinic cell carcinoma (AcCC), adenocarcinoma NOS (ACNOS), carcinoma ex pleomorphic adenoma (CAexPA), and squamous cell carcinoma (SqCC), respectively. The average cumulative EGFR scores were 82, 91, 80, 1, 52, 93, and 185 for MEC, SDC, AdCC, AcCC, ACNOS, CAexPA, and SqCC, respectively.</p></div><div><h3>Conclusions</h3><p>EGFR positive scores and cumulative EGFR scores in SGCs varied among the various histological types, and even in the same histological type. These scores may predict the clinical outcome of SGC treated with EGFR-targeting therapies, such as head and neck photoimmunotherapy, and need to be evaluated in future studies.</p></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 4","pages":"Pages 755-760"},"PeriodicalIF":1.7,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141291714","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":"Ocular torsion induced by Coriolis stimulation","authors":"Natsuki Aoki,&nbsp;Ayame Yamazaki,&nbsp;Keiji Honda,&nbsp;Takeshi Tsutsumi","doi":"10.1016/j.anl.2024.05.011","DOIUrl":"https://doi.org/10.1016/j.anl.2024.05.011","url":null,"abstract":"<div><h3>Objective</h3><p>The present study aimed to observe and analyze the ocular movements induced by Coriolis stimulation (eccentric pitch while rotating: PWR) that induces Coriolis forces on the vestibular apparatus of healthy human individuals.</p></div><div><h3>Methods</h3><p>A total of 31 healthy subjects participated in the study. Eccentric PWR was performed on 27 subjects, by pitching the participants’ heads forward and backward at an angle of 30° each on an axis parallel and 7 cm below inter-aural axis, at a frequency of 0.5 Hz while on a chair rotating at a constant angular velocity of 97.2°/s on the earth-vertical axis. Ocular movements during stimulation were recorded using three-dimensional video-oculography. As a subsidiary analysis, 0.5 Hz head roll tilt was used as another stimulus that also induced torsional ocular movements. The forces induced on the vestibular apparatus, and phases of ocular torsion against the stimulus were calculated from the observed data.</p></div><div><h3>Results</h3><p>In the Coriolis stimulation during rightward yaw rotation, a rightward ocular torsion of 4.8° on average, was observed when the head pitched forward, and the direction of ocular torsion reversed when the head pitched backward. During leftward yaw rotation, these relationships were reversed with an average amplitude of 4.7° The phase of ocular torsion preceded that of Coriolis force by 0.2 s during rightward rotation and 0.14 s during leftward rotation. There were no significant differences in amplitude or phase between the directions of rotation. The phase lead of 0.5 Hz roll-tilt was significantly smaller than that of Coriolis stimulation (<em>p</em> &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>Coriolis stimulation induced a specific pattern of ocular torsion, where its direction and phase suggested that the mechanism likely involved both the otolith and semicircular canals. Further studies may provide a clue to the magnitude of the otolith and semicircular canal contributions.</p></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 4","pages":"Pages 738-746"},"PeriodicalIF":1.7,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141286516","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":"Idiopathic sudden sensorineural hearing loss: A review focused on the contribution of vascular pathologies","authors":"Nobuyoshi Tsuzuki ,&nbsp;Koichiro Wasano","doi":"10.1016/j.anl.2024.05.009","DOIUrl":"https://doi.org/10.1016/j.anl.2024.05.009","url":null,"abstract":"<div><p>Idiopathic sudden sensorineural hearing loss (ISSNHL) is characterized by abruptly appearing hearing loss, sometimes accompanied by vertigo. Vascular pathologies (e.g., cochlear ischemia, or cochlear infarction) are one of the most likely causes of ISSNHL. This review aims to present current understanding of inner ear anatomy, clinical features of ISSNHL, and its treatment strategies. The labyrinthine artery is the only end artery supplying blood to the inner ear, and it has three branches: the anterior vestibular artery, the main cochlear artery, and the vestibulo-cochlear artery (VCA). Occlusion of the VCA can be caused by a variety of factors. The VCA courses through a narrow bone canal. ISSNHL is usually diagnosed after excluding retrocochlear pathologies of sudden sensorineural hearing loss (SSNHL), such as vestibular schwannoma. Therefore, a head MRI or assessing auditory brainstem responses are recommended for patients with SSNHL. Severe SSNHL patients with high CHADS₂ scores, an index of stroke risk, have a significantly lower rate of vestibular schwannoma than severe SSNHL patients with low CHADS₂ scores, suggesting that severe ISSNHL in individuals at high risk of stroke is caused by vascular impairments. Intralabyrinthine hemorrhage causes SSNHL or vertigo, as in ISSNHL. The diagnosis of intralabyrinthine hemorrhage requires careful interpretation of MRI, and a small percentage of patients diagnosed with ISSNHL may in fact have intralabyrinthine hemorrhage. Many studies have reported an association between ISSNHL and atherosclerosis or cardiovascular risk factors (e.g., diabetes mellitus, hypertension, dyslipidemia and cardiovascular disease), and subsequent risk of stroke in patients with ISSNHL may be elevated compared to controls. Increased hearing level on the healthy ear side, high Framingham risk score, high neutrophil-to-lymphocyte ratio, high platelet-to-lymphocyte ratio, and severe white matter lesions may be poor prognostic factors for patients with ISSNHL. The association between thrombosis-related genes and susceptibility to ISSNHL has been reported in many studies (e.g., coagulation factor 2, coagulation factor 5, plasminogen activator inhibitor-1, platelet-associated genes, a homocysteine metabolism-related enzyme gene, endothelin-1, nitric oxide 3, phosphodiesterase 4D, complement factor H, and protein kinase C-eta). Treatment of ISSNHL with the aim of mitigating the vascular impairment in the inner ear includes systemically administered steroids, intratympanic steroid injections, hyperbaric oxygen therapy, prostaglandin E1, defibrinogenation therapy, and hydrogen inhalation therapy, but there is currently no evidence-based treatment for ISSNHL. Breakthroughs in the unequivocal diagnosis and treatment of ISSNHL due to vascular impairment are crucial to improve quality of life.</p></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 4","pages":"Pages 747-754"},"PeriodicalIF":1.7,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S038581462400066X/pdfft?md5=c03d8ac93e523f0e08b1de86f8db487f&pid=1-s2.0-S038581462400066X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141286290","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}