American Journal of Otolaryngology最新文献

{"title":"A preliminary study of fMRI and the relationship with depression and anxiety in Meniere's patients","authors":"Ying Hu ,&nbsp;Dan Bing ,&nbsp;Aiguo Liu ,&nbsp;Shun Zhang ,&nbsp;Juan Li ,&nbsp;Wenzhen Zhu","doi":"10.1016/j.amjoto.2024.104531","DOIUrl":"10.1016/j.amjoto.2024.104531","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine alterations in Blood Oxygen Level-Dependent (BOLD) resting-state functional magnetic resonance imaging (rs-fMRI) signals, utilizing regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF) metrics, within activated brain regions. Additionally, this study aims to explore the relationship between these neural changes and clinical characteristics, as well as emotional states, in patients diagnosed with unilateral Meniere's disease (MD).</div></div><div><h3>Method</h3><div>The study included 24 patients diagnosed with left Meniere's disease (L-MD), 25 patients diagnosed with right Meniere's disease (R-MD), and 23 healthy control subjects. Resting-state blood‑oxygen-level-dependent functional magnetic resonance imaging (rest-BOLD-fMRI) data were preprocessed. A two-sample <em>t</em>-test was employed to compare the regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF) between the patient groups and the control group. Brain regions exhibiting significant differences were further analyzed for correlations with disease duration, vertigo severity, vertigo duration, hearing loss grade, and levels of anxiety and depression.</div></div><div><h3>Results</h3><div>In patients with L-MD, fALFF values were significantly decreased in the right cerebellar hemisphere, middle occipital gyrus, among other regions. In patients with right-sided Ménière's disease (R-MD), fractional amplitude of low-frequency fluctuation (fALFF) values were elevated in the right middle inferior temporal gyrus and fusiform gyrus. Regional homogeneity (ReHo) values exhibited both increases and decreases in the temporal gyrus, parahippocampal gyrus, occipital gyrus, superior marginal gyrus, anterior central gyrus, and fusiform gyrus. In studies examining relational aspects, the parahippocampal gyrus, inferior temporal gyrus, middle occipital gyrus, superior middle occipital gyrus, superior marginal gyrus, and occipital gyrus demonstrated positive or negative correlations with clinical characteristics and emotional states.</div></div><div><h3>Conclusions</h3><div>Patients with unilateral Meniere's disease (MD) exhibited both increased and decreased activation in various brain regions when compared to control subjects. A correlation was identified between these neural activation patterns and clinical characteristics, as well as emotional state, which holds significant implications for clinical treatment, prognosis, and rehabilitation strategies for MD patients.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104531"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816888","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":"Head & neck surgical oncology: Success in private practice","authors":"Courtney B. Shires ,&nbsp;Merry E. Sebelik","doi":"10.1016/j.amjoto.2024.104578","DOIUrl":"10.1016/j.amjoto.2024.104578","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Due to its complexity and multimodality treatment needs, traditional delivery of head and neck cancer care often occurs in a multidisciplinary cancer center, frequently in a university-based program in an urban setting. Fellowship training opportunities for subspecialty-focused head and neck surgeons have increased over recent years. There is a persistent concern that the number of newly minted Head &amp; Neck Surgeons graduating each year outpaces the number of university-based employment opportunities, and that the workforce does not match the job opportunities. Recent publications examine this potential mismatch to better understand career choices, with a 2021 survey revealing that nearly 90 % of fellowship graduates were employed by a university or academic institution and only 10 % reported being in “private practice”. However, it should not be an automatic assumption that academic practice is somehow superior to private practice. Moreover, not every patient can access university-based care, creating a societal mismatch between disease incidence, resources, and access to high quality care. The well-trained Head &amp; Neck Surgeon may be able to deliver excellent care in a satisfying practice setting without an academic affiliation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Two Head &amp; Neck Surgeons who have practiced in both Academic and Community-based (“private”) subspecialty settings offer practical and actionable tips to provide high level evidence-based head and neck surgical care without the trappings of a university, and with a focus on patient-centered care as well as career satisfaction. Further, since graduates of comprehensive otolaryngology training programs receive a robust amount of head and neck surgery training in residency, understanding these practical tips will potentially assist the Comprehensive Otolaryngologist in private practice to expand head and neck services within their practice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;1) Review recently published survey-based reports of practice patterns and career satisfaction of recent HNS fellowship graduates, recognizing self-reported rates of practice settings, academic versus non-university-based (“private practice”). 2) Analyze and report practice structure of HNS graduates over the years 2015 to 2021 to determine rates of practice structure change from academic to private or vice versa, using Public Use Files combined with Google search. 3) Outline tips and pearls for a successful Head &amp; Neck Surgery practice in a non-university-based setting, with 11 practical and actionable items that will allow high level subspecialty care without the traditional attributes of academic employment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Graduates of head &amp; neck surgery fellowships in recent years may perceive a paucity of academic job opportunities. This article reviews practice patterns of recent graduates, and presents practical tips to achieve a s","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104578"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891421","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":"Pediatric neck injuries associated with trampoline use","authors":"Deepthi S. Akella ,&nbsp;Jeremy Walsh ,&nbsp;Maya Raghavan ,&nbsp;Alexandra F. Corbin ,&nbsp;Julia E. Barkell ,&nbsp;Nicole M. Favre ,&nbsp;Michele M. Carr","doi":"10.1016/j.amjoto.2024.104564","DOIUrl":"10.1016/j.amjoto.2024.104564","url":null,"abstract":"<div><h3>Objective</h3><div>Trampolines are popular among children, but trampoline injuries constitute a large number of emergency department visits. The purpose of this study was to determine how often neck injuries occur among children with trampoline-related injuries and to identify the mechanism of injury.</div></div><div><h3>Methods</h3><div>We analyzed the National Electronic Injury Surveillance System (NEISS) database to characterize patient demographics, injury types, injury subsite, and emergency department disposition status associated with trampoline related neck injuries between 2012 and 2021 in the United States. We utilized NEISS code 89 (neck) and code 1233 (trampoline) for our query along and identified patients between 0 and 19 years.</div></div><div><h3>Results</h3><div>Of the 33,929 trampoline injuries, 1436 injuries involved the neck (4.2 %). The overall mean age was 8.0 ± 4.1 years and there were 17,728 (52 %) males and 16,201 (48 %) females in the group. Mean age of children with neck injuries was higher (9.2 ± 3.6 years) compared to children with other injuries (8.0 ± 4.1 years, <em>P</em> &lt; .001). Males had a higher proportion of neck injuries compared to all injuries 800 (56 %) versus females 636 (44 %, <em>P</em> = .007). The most common neck injury was neck strain/sprain with 993 (69 % of neck injuries). The next most common diagnoses included neck contusions at 34 (2 %) and fractures at 20 (1 %). Children with neck injuries were more likely to be discharged prior to admission compared to other trampoline-related injuries (96 % versus 93 %, <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Neck strains/sprains are the most common type of pediatric trampoline-related neck injuries. Older children and males are more likely to have neck injuries while using the trampoline.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104564"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871088","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":"Donor site morbidity of upper extremity flaps in head and neck reconstruction","authors":"Craig Hanna ,&nbsp;David Danis III ,&nbsp;Rotem Kimia ,&nbsp;Heather Merkouris ,&nbsp;Peter Steinwald ,&nbsp;Miriam O'Leary ,&nbsp;Jeremiah Tracy","doi":"10.1016/j.amjoto.2024.104548","DOIUrl":"10.1016/j.amjoto.2024.104548","url":null,"abstract":"<div><h3>Objective</h3><div>This retrospective cohort study aims to compare donor site morbidity of three commonly used upper extremity flaps used in head and neck reconstructive surgery: scapular tip free flap (STFF), radial forearm free flap (RFFF), and pectoralis major pedicled flap (PMPF).</div></div><div><h3>Methods</h3><div>The billing database of an urban, academic, tertiary otolaryngology practice was queried to identify patients who underwent STFF, RFFF, and PMPF from 2020 to 2023. The primary outcome was identification of donor site pain and need for physical therapy (PT) referral after undergoing reconstruction.</div></div><div><h3>Results</h3><div>Seventy-three patients (44M:29F) underwent surgery that utilized upper extremity free or pedicled flaps. Patients undergoing free tissue transfer (FTT) were 5.455 times more likely to require PT referral compared to patients undergoing pedicled tissue transfer (PTT). Patients undergoing FTT were 3.417 times more likely to report donor site pain compared to patients undergoing PTT. There were no differences in post-operative PT referrals or post-operative donor site pain when comparing STFF or RFFF groups. Importantly, RFFF were primarily all fasciocutaneous flaps (33/35).</div></div><div><h3>Conclusions</h3><div>These findings have important implications when counselling patients regarding reconstructive options for complex head and neck surgery defects.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104548"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891420","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":"Efficacy of combination therapy with mometasone and montelukast versus mometasone alone in treatment of adenoid hypertrophy in children: A systematic review and meta-analysis","authors":"Meghna Joseph ,&nbsp;Mrinal Murali Krishna ,&nbsp;Ancy Jenil Franco ,&nbsp;Laura Jekov ,&nbsp;Renan Yuji Ura Sudo ,&nbsp;Thamiris Dias Delfino Cabral","doi":"10.1016/j.amjoto.2024.104566","DOIUrl":"10.1016/j.amjoto.2024.104566","url":null,"abstract":"<div><h3>Introduction</h3><div>Intranasal mometasone and oral montelukast have been found to be effective for adenoid hypertrophy in children. We aimed to compare the efficacy of combination therapy of mometasone and montelukast versus mometasone alone for adenoid hypertrophy in children.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, we systematically searched PubMed, Embase, Cochrane CENTRAL, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> databases for randomized controlled trials (RCTs) comparing combination therapy of mometasone and montelukast with mometasone alone for adenoid hypertrophy in children. The outcomes of interest were rhinorrhea, snoring, mouth breathing, and adenoid/nasopharynx ratio. Data were pooled using a random effects model to generate mean differences (MD).</div></div><div><h3>Results</h3><div>3 RCTs comprising a total of 207 patients were included; (combination therapy <em>n</em> = 104 (50.2 %). Rhinorrhea (MD -1.47; 95 % CI -1.85 to −1.09; <em>p</em> &lt; 0.01; I² = 0 %), snoring (MD -1.33; 95 % CI -1.65 to −1.00; p &lt; 0.01; I² = 0 %), and mouth breathing (MD -1.06; 95 % CI -1.40 to −0.71; p &lt; 0.01; I² = 0 %) were significantly lower in patients treated with combination therapy. No difference was observed in the adenoid/nasopharynx ratio between the groups. However, analysis excluding the study with a high risk of bias showed a significant reduction in the adenoid/nasopharynx ratio (MD −10.73; 95 % CI −13.56 to −7.90; <em>p</em> &lt; 0.01; I² = 0 %) in the combination therapy group. During the 3-month follow-up period after cessation of treatment, adenoid/nasopharynx ratio, rhinorrhea, snoring, and mouth breathing were significantly lower in the combination therapy group.</div></div><div><h3>Conclusion</h3><div>In children with adenoid hypertrophy, combination therapy reduced rhinorrhea, snoring, mouth breathing, and adenoid/nasopharynx ratio at the end of the treatment period and 3 months after treatment cessation.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104566"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876023","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":"Improved visualization of the inferior tympanic and mastoid canaliculi with photon counting detector CT","authors":"James P. McDonald ,&nbsp;Paul J. Farnsworth ,&nbsp;Norbert G. Campeau ,&nbsp;Shuai Leng ,&nbsp;Matthew L. Carlson ,&nbsp;John C. Benson ,&nbsp;Ian T. Mark ,&nbsp;John I. Lane","doi":"10.1016/j.amjoto.2024.104585","DOIUrl":"10.1016/j.amjoto.2024.104585","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the performance of the photon-counting detector (PCD)-CT versus a state-of-the-art energy-integrating detector (EID)-CT to identify segments of the inferior tympanic canaliculus (Jacobsons nerve) and the mastoid canaliculus (Arnolds nerve).</div></div><div><h3>Materials &amp; methods</h3><div>Patients were prospectively recruited to undergo temporal bone CT on both EID-CT (Siemens Somatom Force) and PCD-CT (Siemens NAEOTOM Alpha) scanners under an IRB-approved protocol. Three neuroradiologists reviewed cases by consensus comparing the ability to identify the proximal, mid, and distal segments of the inferior tympanic canaliculus/Jacobsons nerve and mastoid canaliculus/Arnolds nerve on each scanner using 5-point Likert scales (with 1 indicating EID is far superior to PCD, 3 indicating they are equivalent, and 5 indicating PCD is far superior to EID).</div></div><div><h3>Results</h3><div>Forty temporal bones were analyzed. Average Likert scores for the ability to evaluate the proximal, mid, and distal aspects of inferior tympanic canaliculus/Jacobsons nerve on the PCD compared to EID scanner were 4.5 (SD = 0.6), 4.2 (0.4), and 4.1 (0.3). The scores for the mastoid canaliculus/Arnolds nerve were 4.0 (0.4), 4.1 (0.4), and 4.0 (0.4). Overall, the PCD scanner performed better than EID for image quality (Median = 4.2, 95 % CI = [4.1, 5.0], <em>p</em>-value &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>PCD-CT provides superior visualization of the proximal, mid, and distal aspects of the inferior tympanic canaliculus/Jacobsons nerve and mastoid canaliculus/Arnolds nerve compared to EID-CT examinations. The improved visualization of these nerves could be important for characterization of subtle pathology involving these structures, such as tympanic paraganglioma or nodular perineural spread.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104585"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913725","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":"Assessing the presence of rhinological surgery on social media: Factors influencing searches","authors":"Ogechukwu S. Anwaegbu ,&nbsp;Delayne M. Coleman ,&nbsp;Janisah Amirah I. Saripada ,&nbsp;Smiti Gandhi ,&nbsp;Cody D. Luong ,&nbsp;Michel M. Adeniran ,&nbsp;Brian J. McKinnon","doi":"10.1016/j.amjoto.2024.104595","DOIUrl":"10.1016/j.amjoto.2024.104595","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the quality and engagement of rhinology-related educational videos shared by healthcare providers on Instagram.</div></div><div><h3>Methods</h3><div>The top 150 videos on Instagram for <em>#SinusSurgeryEducation</em>, #<em>TurbinateReductionEducation</em>, and #<em>SeptoplastyEducation</em> were selected. Videos were categorized by provider's specialty and analyzed for engagement metrics (likes, comments, shares, views), video duration, and hashtags. The Patient Education Materials Assessment Tool Audio/Visual (PEMAT-A/V) was used to assess the understandability and actionability of the medical educational videos.</div></div><div><h3>Results</h3><div>Sixty-three videos were analyzed: septoplasty education (26 videos), turbinate reduction education (17 videos), and sinus surgery education (20 videos). Of these, 88 % were classified as medical education content, while 12% focused on before-and-after surgery visualizations.</div><div>Among the educational content, 38 % were by otolaryngologists, 32 % by plastic surgeons, and 30 % by other providers such as anesthesiologists and chiropractors. Content created by plastic surgeons received higher engagement metrics compared to otolaryngologists. The average PEMAT-A/V scores were 75 % for understandability and 37 % for actionability.</div></div><div><h3>Conclusion</h3><div>Our analysis reveals that plastic surgeons and otolaryngologists are using social media for medical education, with content demonstrating moderate engagement and quality understandability. As social media continues to evolve as a source for disseminating health-related information, providers should strive to understand its mechanisms and impacts.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104595"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942642","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":"ENT specialists' knowledge and their skills in detecting maxillary sinusitis of odontogenic origin, a cross-sectional study","authors":"Ali Alaqla ,&nbsp;Meshal Alhasoun ,&nbsp;Mohammed Asseery ,&nbsp;Saud Altheyabi ,&nbsp;Fathima Fazrina Farook ,&nbsp;Hajar Albanyan ,&nbsp;Mohammad T. Al-Kadi","doi":"10.1016/j.amjoto.2024.104587","DOIUrl":"10.1016/j.amjoto.2024.104587","url":null,"abstract":"<div><h3>Background</h3><div>Odontogenic maxillary sinusitis (OMS) is recognized in literature, but diagnosing it is challenging due to its different and overlapping clinical presentations of it. Misdiagnosis can lead to persistent symptoms and clinical burden. Interestingly, recent guidelines from the American Academy of Otolaryngology-Head and Neck Surgery lack recommendations for dental evaluation in adult sinusitis cases.</div></div><div><h3>Aim</h3><div>To assess ENT physicians' knowledge and skills in diagnosing maxillary sinusitis of odontogenic origin. This study may emphasize the importance of raising awareness to help in proper diagnosis, timely referral, and efficient management of patients with maxillary sinusitis of odontogenic origin.</div></div><div><h3>Methods</h3><div>A cross-sectional analytical study on 210 ENT specialists in Riyadh, Saudi Arabia to evaluate their knowledge and ability in detecting OMS electronically.</div></div><div><h3>Results</h3><div>Our sample included a total of 30 (14.29%) residents, 108 (51.43%) specialists, and 72 (34.28%) consultants. In cases of unilateral maxillary sinusitis, 61.43% of all participants reported that a dental examination was unnecessary. The regression analysis showed a significant interaction effect between the number of sinusitis cases per week and being a specialist (<em>p</em> = 0.0370). Conversely, there was no significant interaction effect between sinusitis cases per week and being a consultant (<em>p</em> = 0.1408).</div></div><div><h3>Conclusion</h3><div>ENT physicians underestimated the odontogenic etiology for unilateral OMS significantly. This study highlights the importance of targeted education to improve OMS detection and treatment and, ultimately, patient outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104587"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942645","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":"Mepolizumab in chronic rhinosinusitis with nasal polyps: Real life data in a multicentric Sicilian experience","authors":"Cosimo Galletti ,&nbsp;Federico Sireci ,&nbsp;Giovanna Stilo ,&nbsp;Maria Antonietta Barbieri ,&nbsp;Giuliano Messina ,&nbsp;Riccardo Manzella ,&nbsp;Daniele Portelli ,&nbsp;Andrea Guglielmo Zappalà ,&nbsp;Mariut Diana ,&nbsp;Silvia Frangipane ,&nbsp;Angelo Immordino ,&nbsp;Francesco Lorusso ,&nbsp;Francesco Dispensa ,&nbsp;Francesco Ciodaro ,&nbsp;Francesco Freni ,&nbsp;Francesco Galletti ,&nbsp;Salvatore Gallina ,&nbsp;Ignazio La Mantia ,&nbsp;Bruno Galletti","doi":"10.1016/j.amjoto.2024.104597","DOIUrl":"10.1016/j.amjoto.2024.104597","url":null,"abstract":"<div><h3>Background</h3><div>Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by a type 2 pattern of inflammation. Mepolizumab was approved for the treatment of CRSwNP in 2021. However, there is a lack of real-life studies.</div></div><div><h3>Aim</h3><div>This work aimed to evaluate the effectiveness and safety profile of Mepolizumab during the first year of treatment in a real-life setting.</div></div><div><h3>Methods</h3><div>A multicentric observational cohort study was carried out. A total of 67 patients were enrolled in the Otorhinolaryngology Unit of the three University Hospitals and considered for Mepolizumab therapy. All recorder characteristics were age (at the first Mepolizumab application visit), sex, smoke habits, previous local and systemic corticosteroid therapy, history of endoscopic sinus surgery, number of previous endoscopic sinus surgery, concomitant asthma, history of an allergic condition, immunoglobulin E (IgE), allergy to nonsteroidal anti-inflammatory drugs (NSAIDs), Aspirin Exacerbated Respiratory Disease (AERD), other comorbidities associated, blood eosinophils, nasal polyp score, sinonasal outcome test 22 (SNOT 22), sniffin' stick test, the start date of Mepolizumab therapy and number of doses of Mepolizumab and eventually, Mepolizumab's adverse events related to administration. The Wilcoxon test for dependent samples was performed to compare variables. Statistical significance was assumed for <em>p</em> values &lt; 0.05.</div></div><div><h3>Results</h3><div>A statistically significant reduction in SNOT-22 and NPS was shown in the 6th and 12th month compared to baseline values (p &lt; 0.001 for both comparisons). A statistically significant increase value at the Sniffin' sticks test was shown in the 6th and 12th month compared to baseline values (<em>p</em> &lt; 0.001 for both comparisons).</div><div>At the 12-month follow-up, according to EUFOREA indications, all patients were considered to remain in treatment with Mepolizumab and continued the treatment because of a reduced NPS, improved quality of life, and a reduced need for system corticosteroids.</div></div><div><h3>Conclusions</h3><div>This multi-centric real-life study supported the effectiveness of Mepolizumab in patients with severe uncontrolled CRSwNP in the improvement of quality of life, the severity of symptoms, polyp size reduction, and smell function. Our data also support the safety profile of monoclonal therapy with Mepolizumab.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104597"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998353","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":"The effects of increased screen time on post-surgical pain and pain memory among children with sleep-disordered breathing","authors":"Pengcheng Ma ,&nbsp;Gang Li ,&nbsp;Dongdong Meng ,&nbsp;Ruijia Gan ,&nbsp;Ping Fang ,&nbsp;Chaobing Gao ,&nbsp;Dong Wang","doi":"10.1016/j.amjoto.2024.104550","DOIUrl":"10.1016/j.amjoto.2024.104550","url":null,"abstract":"<div><div>Adenotonsillectomy procedures can provide effective relief to children affected by sleep-disordered breathing (SDB), but the post-adenotonsillectomy pain management remains challenging, and the most effective approach to managing postoperative pain in these cases remains uncertain. The use of electronic media as a form of distraction therapy aimed at mitigating postoperative pain in children, it is unknown whether increases in screen time can effectively reduce persistent postoperative pain intensity or the incidence of negatively biased pain memories. A total of 107 SDB children undergoing adenotonsillectomy were enrolled and divided into two groups. Children in the intervention group were allowed to increase their screen time, while screen time was restricted for children in the control group. Child-reported pain intensity and negatively biased pain memories, pain-related fear were analyzed. The results indicated that no significant differences in initial postoperative pain intensity or fear were observed among groups. However, children in the intervention group did exhibit significantly reduced remembered Day 1 postoperative pain intensity (ηp² = 0.043, <em>p</em> = 0.035), memory of worst pain intensity (ηp² = 0.047, <em>p</em> = 0.027), and memory of worst pain-related fear (ηp² = 0.042, <em>p</em> = 0.036) as compared to controls. Subgroup analyses based on age and gender indicated that males and school-aged children presented with lower scores for negatively biased pain memories. Our study exhibited the association between screen time and post-surgical pain intensity and negatively biased pain memories, These findings suggest that increasing screen time represents an effective approach to the postoperative management of negatively biased pain memories in certain subsets of children with SDB.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104550"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845610","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}