MN Zakaria
Publication date 01-05-2023
Publication date 01-05-2023
N Yilmaz,E Soylemez,MB Sanuc,MH Bayrak,V Sener
Publication date 01-05-2023
Objective This study aimed to investigate the wideband tympanometry (WBT) findings in the elderly with presbycusis who have normal outer and middle ears according to otoscopic examination and traditional tympanometry, and to determine whether there is a relationship between the middle ear wideband absorbance value and the pure tone air–bone gap (ABG) observed especially at mid-high frequencies in the elderly. Methods The study included 30 elderly with presbycusis (> 65 years old, presbycusis group) and 30 healthy individuals (control group) between the ages of 18 and 55. Pure tone air conduction and bone conduction thresholds of all participants were determined and WBT was applied to all participants. Resonance frequency (RF), absorbance ratios at peak pressure (PPAR) and ambient pressure (APAR) values were analyzed. Results The RF value of the presbycusis group was lower than the control group (p < 0.05). APAR and PPAR values at 2000 and 4000 Hz and mean absorbance values of the presbycusis group were lower than the control group (p < 0.05). APAR was higher at 500 Hz in males than females (p < 0.05), but there was no difference between genders in RFs (p > 0.05). A moderate negative correlation was observed between ABG and both PPAR and APAR at 4000 Hz in presbycusis group (p < 0.05). Conclusion it was determined that there was a decrease in RF and absorbances at 2000 and 4000 Hz in the elderly with presbycusis. Aging affects not only the inner ear but also the conduction mechanism of the middle ear. Our findings may be effective in a more accurate and reliable interpretation of WBT in the elderly with presbycusis.
Pubmed PDF WebKT Lin,CJ Lu,YH Young
Publication date 01-05-2023
Purpose This study adopted the cervical and ocular vestibular-evoked myogenic potential (cVEMP and oVEMP) tests in Meniere’s disease (MD) patients to correlate them with vestibular endolymphatic hydrops (EH) on MR images. Methods A total of 25 patients with unilateral definite MD identified by positive cochlear hydrops on MR images were enrolled. All patients underwent audiometry, cVEMP test and oVEMP test, followed by MR imaging for confirmation. Results A significantly declining sequence of abnormality rates in MD patients was identified from the audiometry (92%), cVEMP test (52%) to the oVEMP test (40%), which was consistent with a significantly decreasing order of prevalence of EH on MR images running from the cochlea (100%), saccule (56%) to the utricle (52%). The cVEMP test for detecting the saccular hydrops revealed a sensitivity of 62%, while the oVEMP test for assessing the utricular hydrops showed a sensitivity of 70%. However, correlating VEMP results with vestibular hydrops did not show any significant relationship. In addition, mean hearing level (MHL) at four frequencies (500, 1000, 2000, and 3000 Hz) of Grade I cochlear hydrops (51 ± 19 dB) did not significantly differ from Grade II cochlear hydrops (53 ± 19 dB).
Conclusion Limitations of the updated MR imaging for visualizing the hydrops comprised: (1) failure to correlate vestibular hydrops with VEMP results, and (2) failure to correlate grade of cochlear hydrops with MHL. The reason is probably because updated MR imaging fails to identify distorted contour of the cochlea/utricle/saccule. Further advanced technique using ultrahigh resolution of fine structures in the inner ear compartments is essential to promote a wider use of MR imaging.
S Goksel,G Unsal,H Cakir Karabas,AF Erturk,I Ozcan,K Orhan
Publication date 01-05-2023
Purpose Accessory sphenoidal septum (ASS) is a septal variation that exists in addition to the primary septum of the sphenoid sinus and can be found in or near anatomically essential structures. This study aimed to investigate the relationships between protrusions of vital structures around the sphenoid sinus and the ASSs. Methods This cross-sectional retrospective study is based on the analysis of CBCT scans of 314 patients in axial, coronal, and sagittal planes with 0.2–0.3 slice thicknesses. Optic nerve (ON), internal carotid artery (ICA), both ON and ICA, maxillary nerve (MN), vidian canal (VN) and ASSs were detected, and the relationship between protrusions of these vital anatomical structures and ASS was evaluated. Results Statistically significant relationship was observed between the right Type 1 ON protrusion (p < 0.05) and left Type 1 ON protrusion (p = 0.001); left Type 3 ON protrusion (p < 0.05); right Type 4 ON protrusion (p < 0.05) and ASS. Statistically significant relationship was also observed between the right ICA protrusion and ASS (p < 0.05). The right Type 1 VN protrusion (p = 0.001); left Type 2 VN protrusion (p < 0.001); right and left Type 3 VN protrusions (p < 0.001) were found to be significantly associated with the ASS. Conclusions ASSs have significant associations with some protrusions, and they tend to cause potentially severe complications in endoscopic sinus surgery. This variability requires a comprehensive understanding of regional sphenoid sinus anatomy with detailed three-dimensional tomographic imaging.
Pubmed PDF WebNM Weiss,TM Breitsprecher,A Pscheidl,D Bächinger,S Volkenstein,S Dazert,R Mlynski,S Langner,P Roland,A Dhanasingh
Publication date 01-05-2023
Objectives Enlarged vestibular aqueduct (EVA) is a common finding associated with inner ear malformations (IEM). However, uniform radiologic definitions for EVA are missing and various 2D-measurement methods to define EVA have been reported. This study evaluates VA volume in different types of IEM and compares 3D-reconstructed VA volume to 2D-measurements. Methods A total of 98 high-resolution CT (HRCT) data sets from temporal bones were analyzed (56 with IEM; cochlear hypoplasia (CH; n = 18), incomplete partition type I (IPI; n = 12) and type II (IPII; n = 11) and EVA (n = 15); 42 controls). VA diameter was measured in axial images. VA volume was analyzed by software-based, semi-automatic segmentation and 3D-reconstruction. Differences in VA volume between the groups and associations between VA volume and VA diameter were assessed. Inter-rater-reliability (IRR) was assessed using the intra-class-correlation-coefficient (ICC). Results Larger VA volumes were found in IEM compared to controls. Significant differences in VA volume between patients with EVA and controls (p < 0.001) as well as between IPII and controls (p < 0.001) were found. VA diameter at the midpoint (VA midpoint) and at the operculum (VA operculum) correlated to VA volume in IPI (VA midpoint: r = 0.78, VA operculum: r = 0.91), in CH (VA midpoint: r = 0.59, VA operculum: r = 0.61), in EVA (VA midpoint: r = 0.55, VA operculum: r = 0.66) and in controls (VA midpoint: r = 0.36, VA operculum: r = 0.42). The highest IRR was found for VA volume (ICC = 0.90). Conclusions The VA diameter may be an insufficient estimate of VA volume, since (1) measurement of VA diameter does not reliably correlate with VA volume and (2) VA diameter shows a lower IRR than VA volume. 3D-reconstruction and VA volumetry may add information in diagnosing EVA in cases with or without additional IEM.
Pubmed PDF WebM Basoz Behmen,N Guler,E Kuru,N Bal,O Gedik Toker
Publication date 01-05-2023
Background Speech-ABR is an auditory brainstem response that evaluates the integrity of the temporal and spectral coding of speech in the upper levels of the brainstem. It reflects the acoustic properties of the stimulus used and consists of seven major waves. Waves V and A represent the onset of the response; wave C transition region; D, E, and F waves periodic region (frequency following response); and wave O reflects the offset of the response. Purpose The aim of this study is to evaluate the clinical availability of the speech-ABR procedure through a literature review. Methods Literature search was conducted in Pubmed, Google Scholar, Scopus and Science Direct databases. Clinical studies of the last 15 years have been included in this review and 60 articles have been reviewed. Results As a result of the articles reviewed, it was seen that most of the studies on speech ABR were conducted with children and young people and generally focused on latency analysis measurements. Most used stimulus is the /da/ syllable. Conclusions Speech ABR can objectively measure the auditory cues important for speech recognition and has many clinical applications. It can be used as a biomarker for auditory processing disorders, learning disorders, dyslexia, otitis media, hearing loss, language disorders and phonological disorders. S-ABR is an effective procedure that can be used in speech and language evaluations in people with hearing aids or cochlear implant. It may also be of benefit to the aging auditory systems ability to encode temporal cues.
Pubmed PDF WebS Lembacher,S Gantner,B Uhl,M Holzer,M Patscheider,JM Hempel
Publication date 01-05-2023
Purpose The aim of the present study was to assess the efficacy of the Ronch®AP palatal device in treating patients with moderate and severe forms of obstructive sleep apnea syndrome. Methods In a randomized controlled trial 22 patients were examined with the Ronch®AP palatal device after 4 weeks of usage. Their results were compared to a control group of 30 patients who did not receive any treatment during this time. All patients included did not tolerate CPAP therapy. Among other parameters the apnea–hypopnea index (AHI) was measured using nocturnal cardiorespiratory polysomnography. Daytime sleepiness was assessed using Epworth Sleepiness Scale. Pittsburgh Sleep Quality Index was used to analyze sleep quality. Results Using the Ronch®AP palatal device AHI was reduced from an average of 35.34 ± 14.9/h to 19.18 ± 14.93/h, whereas the control group only showed a minimal mean reduction from 31.32 ± 12.76/h to 29.37 ± 17.11/h. The difference in reduction between the two randomized groups was highly significant (d = − 14.2, 95% CI 5.9–22.6, t = 3.4, df = 49.9, p = 0.001). Epworth Sleepiness Scale score was lowered from 9.18 ± 4.73 to 7.82 ± 4.14 on average and sleep quality improved by − 1.91 ± 2.31. Both changes were also statistically relevant (p < 0.005). Conclusions The Ronch®AP device is an effective alternative treatment option for patients suffering from moderate and severe forms of obstructive sleep apnea syndrome and not tolerating CPAP therapy. Trial registration number 407-16 with approval from the local ethical committee (Ethikkommission der Medizinischen Fakultät der LMU München).
Pubmed PDF WebR Sousa,M Lobo,H Cadilha,T Eça,J Campos,L Luis
Publication date 01-05-2023
Background Endolymphatic hydrops (EH) is universal in Ménière´s disease (MD). Given its chronic course, with variable interval before complete clinical picture is installed, it seems relevant to understand the progression of vestibular EH and hemato-perilymphatic barrier disruption in patients with MD and monosymptomatic presentations. Methods 239 consecutive patients were referred to us with suspected hydropic ear disease. 50 individuals accepted to participate in this study—final longitudinal sample included 24 patients (7 D1, 7 D2, 10 D3). Control group included ten patients. At recruitment, a clinical and MRI re-evaluation was done (3T, intravenous technique) (MR2) and 2 years after MRI was repeated (MR3). Previous MRI (MRI1) were retrospectively evaluated. Patients were classified as definite (D1), possible (D2) and atypical (D3—monosymptomatic) MD. Control group included non-typical symptoms (C2/C3) and 6 asymptomatic (C1). Vestibular endolymphatic ratio (vER) and grading, presence/absence of cochlear EH, asymmetry of cochlear perilymphatic enhancement, and rate of progression of vER were assessed by two independent neuroradiologists and compared between patient and control groups (index ear). Results EH was universal and pronounced in D1 and remained stable. vER progression was more variable and higher in some D3 patients (index ear worse) and in D2 (non-index), although this observation was not statistically significant. Conclusions Considering that many probable and monosymptomatic presentations progress years later into definite MD and given the bilateral tendency of the disease, these findings may indicate that there is an initial accelerated worsening of EH in initial stages of the disease. These data should be confirmed with controlled and larger sample studies.
Pubmed PDF WebC Metcalfe,C Leonard,J Muzaffar,C Coulson
Publication date 01-05-2023
Purpose This study aims to gain in-depth feedback on patient perceptions of remote assessment in otology, to better inform the development of a telemedicine pathway for new otology referrals. Methods A qualitative descriptive approach was employed to analyse semi-structured interviews from 14 patients seen in a routine otology clinic. Results Patients were generally accepting of the proposed telemedicine pathway. Key themes included maintaining quality of care, adequate training for facilitators, reducing waiting times, appropriate actioning of clinic outcomes and anxiety surrounding the use of technology. Conclusions Our proposed telemedicine pathway for new otology referrals is acceptable to patients, provided there is no compromise in the standard of their care versus a traditional pathway. These results further our understanding of remote assessment in otology from the patient perspective and may help to inform the development of such pathways outside of our centre.
Pubmed PDF WebW Ming,J Zuo,J Han,J Chen
Publication date 01-05-2023
Background The optimal treatments for adult benign laryngotracheal stenosis presently remains controversial. The majority of the disadvantages of endoscopic interventions with high recurrence rate and open surgical therapy accompanied by sophisticated techniques, complication and mortality, highlights the dilemma of option for treatments. Purpose To compare endoscopic treatments with open surgical interventions in adult patients with benign laryngotracheal stenosis, analyze their clinical outcomes, recurrence, complication and mortality. Methods In the meta-analysis, the databases including Pub Med, Embase, Ovid and Web of Science were searched for studies reporting adult benign laryngotracheal stenosis, and clinical outcomes were compared. The duplicate publications, reviews, comments or letters, conference abstracts, case reports were excluded. The random effect model was used for calculating the pooled effect estimates. Results Eight studies (1627 cases) referring to six retrospective and two prospective researches were ultimately included in the meta-analysis. The decreased risk estimates of recurrence rate in patients receiving open surgical interventions were detected, comparing with endoscopic interventions (P < 0.05). Subgroup analysis revealed that decreased risk estimates of restenosis rate were also observed in patients receiving open surgical interventions compared with endoscopic interventions (P < 0.05), based on prospective studies, Europe and America, < 2-year follow-up, laryngeal stenosis, stenotic length without inter-group difference or stenotic grade II alone. However, there were no statistically significant difference of recurrence rate between the two interventions (P > 0.05) based on retrospective studies, South Asia and Africa, ≥ 2-year follow-up, involving tracheal lesion, stenotic length with inter-group difference, or stenotic grades of I–IV. No notable difference in the incidence of complication or mortality were identified. Conclusions Open surgical interventions were more suitable for most laryngotracheal stenosis without contraindications. Endoscopic interventions are increasingly being used to treat simple laryngotracheal stenosis, as well as complex airway stenosis in carefully selected cases. Multi-center prospective randomized controlled trials should be conducted to search for the standard treatments for laryngotracheal stenosis.
Pubmed PDF WebDC Guven,E Erul,F Yilmaz,S Yasar,HC Yildirim,F Ercan,Y Kaygusuz,K Cayiroz,MT Ucdal,F Yesil,G Yazici,M Cengiz,I Gullu,S Aksoy
Publication date 01-05-2023
Purpose A significant portion of patients with locally advanced head and neck squamous cell carcinoma (HNSCC) relapse despite multimodality treatment denoting the need for biomarkers. The pan-immune-inflammation value (PIV) is a recently developed blood count-based prognostic biomarker. We evaluated the relationship between PIV and survival in locally advanced HNSCC patients treated with chemoradiotherapy (CRT). Methods A total of 199 patients who underwent CRT at Hacettepe University Oncology Hospital were included. The relationship between clinical and laboratory parameters with overall survival (OS) and disease-free survival (DFS) was analyzed by multivariate analyses. Results The median age was 59 years and 90.5% of the patients were male. 66.8% of the patients had laryngeal primaries, and 78.9% had T3–T4 disease. 84.9% of the patients received CRT with cisplatin. The optimal PIV threshold value was calculated as 404 in ROC analyses. This PIV value had 75.8% sensitivity and 70.4% specificity for OS prediction (AUC 0.781; 95% CI 0.715–0.846; p < 0.001). In multivariate analyses, high PIV levels (≤ 404 vs. > 404, HR 2.862; 95% CI 1.553–5.276; p = 0.001), higher NLR (≤ 2.5 vs. > 2.5, HR 1.827; 95% CI 1.017–3.281; p = 0.044) levels and ECOG performance score of 2 (HR 2.267; 95% CI 1.385–3.711; p = 0.001) were associated with shorter OS. These factors were associated with shorter DFS also (HR for PIV 2.485, 95% CI 1.383–4.467, p = 0.002). Conclusions We observed shorter OS and DFS in locally advanced HNSCC patients with high PIV levels. If prospective studies support our findings, the PIV score could be a prognostic biomarker in HNSCC.
Pubmed PDF WebE Zloczower,N Bartov,R Allon,M Sokolov,Y Lahav,H Shoffel-Havakuk
Publication date 01-05-2023
Objective Previous data correlate preterm and low birth weight (LBW) with acute otitis media, but there is a gap concerning the relations with acute mastoiditis (AM). This study investigates the effect of LBW and preterm birth on AM disease severity, neuro-otological complications, and recurrence. Study design Retrospective cohort. Setting Tertiary medical center. Methods The cohort is retrospective in nature consisting of 294 children with AM admitted between 1999 and 2020.
Data collection included: patient gestational age and birth weight, signs and symptoms, physical examination, laboratory tests, imaging findings, and long-term outcomes. Results 294 cases of AM were included, 41/281 (15%) had LBW (< 2500 g), and 46/294 (15.7%) were preterm (gestational age < 37 weeks). We found no significant differences in laboratory tests, imaging studies (CT), rate of mastoidectomy performed, or late complications between LBW and normal birth weight (NBW) and between preterm and normal gestational age children. LBW children tended to develop AM at an older age compared with NBW children, 2.28 + 1.64 Vs. 1.84 + 1.4 years, respectively (p-value = 0.016). Additionally, preterm children were more prone to develop a second event of AM, with a shorter interval between these episodes. Conclusions LBW and preterm birth are not independent risk factors for disease severity, need for intervention, or future complications in AM. Yet, LBW children present with AM at an older age, and preterm children are more prone for recurrent episodes of AM with a shorter interval between episodes suggesting a distinct disease course in these populations.
Q Chen,L Shen,S Li
Publication date 01-05-2023
Objectives To evaluate the tumor volume reduction after induction chemotherapy (IC) with gemcitabine plus cisplatin (GP) and to build prediction models for tumor volume reduction in nasopharyngeal carcinoma (NPC). Methods NPC patients who received GP IC were retrospectively enrolled. The gross tumor volume of the nasopharynx and lymph nodes (GTVnx and GTVnd) were contoured before and after IC. Univariate and multivariate analyses were performed to identify associated factors. Nomogram models were constructed to predict the possibility of tumor volume reduction. Results A total of 192 patients were enrolled. The mean relative volume reduction for GTVnx and GTVnd was 29.66% and 31.75%, respectively. The volume reduction of GTVnx and GTVnd had a weak association (r = 0.229, p < 0.001). For GTVnx volume reduction, pre-treatment neutrophil count (p = 0.043), lymphocyte count (p = 0.026), LDH level (p = 0.005), and BMI (p = 0.020) were independently associated factors. For GTVnd volume reduction, pre-treatment EBV–DNA (p = 0.029), GTVnd volume (p < 0.001), eosinophil count (p = 0.043), NLR (p = 0.039), LDH level (p = 0.026), and serum potassium level (p = 0.027) were independently associated factors. For the GTVnx nomogram model, areas under the receiver-operating characteristic curve (AUC) were 0.702 and 0.698 for the training and validation cohorts, respectively. For the GTVnd nomogram model, the AUC was 0.872 and 0.758 for the training and validation cohorts, respectively. Conclusions Tumor volumes reduce significantly after GP induction chemotherapy. Nomogram models for predicting the possibility of tumor volume reduction are built.
Pubmed PDF WebY Zhao,T Li,G Zhang,X Liang,Y Wang,J Kang,J Ma
Publication date 01-05-2023
Objective Bariatric surgery (BS) is considered one of the most effective treatments for obese individuals with Obstructive Sleep Apnea (OSA). However, otolaryngologists have raised concerns about the structural alterations caused by BS on the upper respiratory tract, especially, on the pharyngeal cavity. Methods In this study, we recruited 42 individuals who underwent BS at our hospital. They were divided into two groups based on apnea–hypopnea index (AHI): mild group (5 ≤ AHI < 15) and moderate-severe group (AHI ≥ 15). The participants were followed up for 12 months and several indicators, including body mass index (BMI), polysomnography (PSG), and acoustic pharyngometry (APh), were assessed repeatedly before surgery and at 3, 6, and 12 months (m) after surgery. Results Participants exhibited significant decreases in BMI (F = 128.1, P = 0.001) and total weight loss (F = 176.7, P < 0.001) after BS. The AHI value among obese patients with mild OSA decreased significantly within three months after surgery (0 day vs. 3 months, P < 0.01), and decreased significantly more than 12 months with moderate-to-severe patients (0 day vs. 3 months, 3 months vs. 6 months, 6 months vs. 12 months, P < 0.01). The therapeutic effect of OSA of the mild group was significantly better compared with that of the moderate-severe group at 6 months (mean rank = 28.13 vs. 14.21, P < 0.001) and 12 m (mean rank = 26.75 vs. 15.52, P = 0.001). The APh results revealed that the pharyngeal volume of the two groups increased significantly between 0 day and 6 months after surgery (P < 0.01). The oropharyngeal junction (OPJ) area and the glottal area were increased significantly between 0 day and 6 m after surgery (P < 0.01). Conclusion BS can relieve apnea and OSA symptoms among obese patients with OSA, especially in the early postoperative period. Moreover, OSA severity was closely associated with OPJ and glottal areas, rather than pharyngeal cavity volume.
Pubmed PDF WebV Attali,M Weber,I Rivals,T Similowski,I Arnulf,P Gatignol
Publication date 01-05-2023
Purpose Impairment of genioglossus control is a frequent “non-anatomical” cause of obstructive sleep apnea syndrome (OSAS) in non- or mildly obese patients. Although wake-related compensatory mechanisms prevent the occurrence of obstructive events, the genioglossus control is often impaired during wakefulness. We hypothesized that the lingual motion would be altered during wakefulness in this population in patients with moderate-to-severe OSAS. Methods We included non- or mildly obese participants with suspected OSAS. They underwent a Bucco-Linguo-Facial Motor Skills assessment using the MBLF (“Motricité Bucco-Linguo-Faciale”), which includes an evaluation of 13 movements of the tongue. This was followed by a night-attended polysomnography. We compared patients with moderate-to-severe OSAS (apnea–hypopnea index (AHI) ≥ 15/h; n = 15) to patients without or with mild OSAS (AHI < 15/h; n = 24). Results MBLF total and “tongue” sub-scores were lower in patients with moderate-to-severe OSAS: total z-score − 0.78 − 1.31; 0.103 versus 0.20 − 0.26; 0.31, p = 0.0011; “tongue” z-sub-score (− 0.63 − 1.83; 0.41 versus 0.35 0.26; 0.48, p = 0.014). There was a significant age-adjusted correlation between the “tongue” sub-score and AHI. The logistic regression model for the prediction of moderate-to-severe OSAS gave area under the curve ratio of 88.2% for MBLF score plus age. Conclusions Myofunctional activity of the tongue is impaired during wakefulness in non- or mildly obese patients with moderate-to-severe OSAS. This study supports the lingual myofunctional assessment using the MBLF in screening of moderate-to-severe OSAS. This simple tool could help clinicians to select patients with suspected moderate-to-severe OSAS for polysomnography.
Pubmed PDF WebCF Larsen,M Pedersen
Publication date 01-05-2023
Objectives Deep learning is in this study used through convolutional neural networks (CNN) to the determination of vocal fold nodules. Through high-speed video (HSV) images and computer-assisted tools, a comparison of convolutional neural network models and their accuracy will be presented. Methods The data have been collected by an Ear Nose Throat (ENT) specialist with a 90° rigid scope in the years from 2007 to 2019, where 15.732 high-speed videos have been collected from 7909 patients. A total of 4000 images have been carefully selected, 2000 images were of normal vocal folds and 2000 images were of vocal folds with varying degrees of vocal fold nodules. These images were then split into training-, validation-, and testing-data set, for use with a CNN model with 5 layers (CNN5) and compared to other models: VGG19, Mobile NetV2, and Inception-Res NetV2. To compare the neural network models, the following evaluation metrics have been calculated: accuracy, sensitivity, specificity, precision, and negative predictive values. Results All the trained CNN models have shown high accuracy when applied to the test set. The accuracy is 97.75%, 83.5%, 91.5%, and 89.75%, for CNN5, VGG19, Mobile NetV2, and Inception Res NetV2, respectively. Conclusions Precision was identified as the most relevant performance metric for a study that focuses on the classification of vocal fold nodules. The highest performing model was Mobil NetV2 with a precision of 97.7%. The average accuracy across all 4 neural networks was 90.63% showing that neural networks can be used for classifying vocal fold nodules in a clinical setting.
Pubmed PDF WebA Kara,MT Kalcioglu,Ç Adigul,MT Topcu,M Koçoğlu,B Celik,MS Yilmaz
Publication date 01-05-2023
Purpose To compare the audiological performances of Turkeys most up-to-date bone conduction implant processors. Methods Twenty-six bone-anchored hearing instrument users, thirteen in each group, were evaluated for speech understanding in quiet and several signal-to-noise ratios. Results We noticed the differences at 0.5 and 1 k Hz measurements in free field frequency specific test, aided SRT scores, non-adaptive and adaptive matrix test results for a few conditions created a statistically significant difference in favor of Baha-6®. Conclusions Both processors offer positive gains to their users in noisy and silent conditions. However, the data showed statistically significant differences for some measurements that may be critical for patients in daily practice.
Pubmed PDF WebJR Lechien,SD Le Bon,S Saussez
Publication date 01-05-2023
Objective To investigate safety, feasibility, and effectiveness of platelet-rich plasma (PRP) injection into the olfactory clefts of COVID-19 patients with persistent olfactory dysfunction (OD). Methods From March 2022 to July 2022, COVID-19 patients with persistent OD were consecutively recruited to benefit from PRP injection into the olfactory clefts. Patient pain, annoyance, time of procedure, and adverse events were evaluated. Olfactory function was evaluated at baseline and 2-month post-injection with the olfactory disorder questionnaire (ODQ) and threshold, discrimination, and identification (TDI) test. Results Eighty-seven patients with anosmia (N = 30), hyposmia (N = 40), or parosmia (N = 17) with a mean OD duration of 15.7 months completed the evaluations. The PRP injection was successfully performed in all patients with a mean procedure time of 18.4 ± 3.4 min. The adverse events included transient epistaxis (N = 31), parosmia related to xylocaine spray (N = 10), and vasovagal episode (N = 2). The injection procedure was evaluated as somewhat or moderately painful by 41 (47%) and 22 (25%) patients, respectively. Thirty-seven patients were assessed after 2 months post-injection. The mean ODQ and TDI scores significantly improved from baseline to 2-month post-injection (p < 0.01). The olfactory improvement occurred after a mean of 3.6 ± 1.9 weeks. Conclusion The injection of PRP into the olfactory clefts is safe and associated with adequate patient-reported outcomes. The findings of this preliminary study suggest possible efficacy on subjective and psychophysical evaluations, but future randomized controlled studies are needed to determine the superiority of PRP injection over placebo.
Pubmed PDF WebM Jurlina,J Pupić-Bakrač,A Pupić-Bakrač
Publication date 01-05-2023
Purpose Juvenile angiofibroma (JA) is a benign, but locally invasive tumor of the nasopharynx. Surgical resection of JA is performed through endoscopic (EA), endoscopic-assisted (EAA), or open approaches (OA). The management of these tumors is constantly evolving. We aimed to compare the surgical efficiency and morbidity of EA, EAA, and OA in JA treatment by conducting a systematic review of the literature published over the last 10 years. Methods A systematic review of the English literature on surgical cases of JA published between 2012 and 2022 was performed. Eligible articles were analyzed for individual patient data (IPD) and aggregate patient data (APD). The primary predictor variable was the surgical approach. The primary outcome variable was recurrence rate. Results The search retrieved 75 articles reporting 1586 JA surgical cases; 129 in IPD, and 1457 in APD data sets. Within the IPD data set, recurrence rates were significantly lower in cases completed by EA than that by OA (p < 0.05). There was no significant difference in recurrence rates between the EA and EAA groups (p > 0.05). EAA had a lower recurrence rate than that of OA (p < 0.05). For the APD data set, the recurrence rate following EA was significantly lower than that following OA (p < 0.05). There was no significant difference in recurrence between the EA and EAA groups (p > 0.05), and between the EAA and OA groups (p > 0.05). Conclusions EA represents the method of choice for mild and moderately advanced JA. EAA and OA still play important roles in the treatment of advanced-stage JA.
Pubmed PDF Web