European Archives of Oto Rhino Laryngology 2021-04-11

Palatopharyngeus muscle in pharyngoplasty surgery for OSAS: cut or not to cut?

Publication date 11-04-2021


Pubmed PDF Web

The relevance of CYSLTR1 gene polymorphism to the severity of allergic rhinitis and clinical responsiveness of montelukast in children

M Zhao,H Li,H Li

Publication date 10-04-2021


Purpose The etiology of allergic rhinitis (AR) is closely correlated with the complex interactions between genetic and environmental factors. This study explored the effect of single-nucleotide polymorphisms (SNPs) of CYSLTR1 gene on the risk of AR and clinical response to montelukast treatment in children. Methods A total of 135 children with AR and 100 healthy children were included for subsequent analyses. Genotype and allele distribution of rs321029 SNP of CYSLTR1 gene and inflammatory mediators were detected and compared between AR and healthy children. Results Genotype and allele frequency of rs321029 SNP of CYSLTR1 gene showed no difference between children with AR and controls or between AR cases with different severity. The total montelukast effective rate of wide-type genotype TT children was significantly higher than variants genotype CC children. Conclusion Polymorphism of rs321029 on CYSLTR1 gene is not related to the susceptibility and severity of AR in children, but it is closely related with the efficacy of montelukast on AR.

Pubmed PDF Web

Self-rated vocal complaints relationship to Vocal Tract Discomfort and Singers Voice Handicap Index in Iranian religious singers

MS Seifpanahi,B Bayat,S Ghorbani Gholiabad,M Rezayi

Publication date 10-04-2021


Purpose The religious singing is a popular group of professional voice users in Iran which is performed in a sadness form to persuade the audiences to cry and think to holy persons. This style has its own unique vocal demands and abuses. Therefore, the present study, for the first time, aimed to investigate the prevalence of self-reported vocal complaints, vocal discomfort symptoms, and its effects on the vocal-related life of the Iranian religious singers. Methods In a cross-sectional study, 62 religious singers (28 women, 34 men) completed Singers Voice Handicap Index (SVHI), Vocal Tract Discomfort (VTD), and also a non-standard self-rated vocal complaint question. Spearman correlation test was applied to analyze correlations. Furthermore, 39 non-singers (18 women, 21 men) as a control group participated in this study. Results The religious singer’s mean score of the SVHI test was 34.84 (SD = 24.89). According to the self-rated vocal complaint question, almost 80% of the participants reported mild to the severe vocal complaints that was significantly higher than control group which was about 10%. The self-rated complaints indicated a significant positive correlation with the SVHI and the VTD reported by singers (p ≤ 0.001). The mean scores of the VTD symptoms in singers were significantly greater than control group. There was also a significant positive correlation between the two VTD and SVHI tests (p ≤ 0.001). Conclusion Religious singers are at a great risk of developing voice problems. Therefore, their vocal demands and requirements need to be followed precisely. The SVHI and VTD tests should also be considered as two efficient tools for religious singers.

Pubmed PDF Web

The course of subjective and objective chemosensory dysfunction in hospitalized patients with COVID-19: a 6-month follow-up

M Bertlich,C Stihl,E Lüsebrink,JC Hellmuth,C Scherer,S Freytag,JL Spiegel,I Stoycheva,M Canis,BG Weiss,F Ihler,F Haubner

Publication date 10-04-2021


Purpose It has been established that the infection with SARS-CoV-2 may cause an impairment of chemosensory function. However, there is little data on the long-term effects of SARS-CoV-2 infection on chemosensory function. Methods Twenty three SARS-CoV-2-positive patients diagnosed in spring 2020 with subjective hyposmia (out of 57 positive patients, 40.3%) were compared to SARS-CoV-2-positive patients without hyposmia (n = 19) and SARS-CoV-2-negative patients (n = 14). Chemosensory function was assessed by the Brief Smell Identification Test (BSIT), Taste Strips (TS), Visual Analogue Scales (VAS), and the SNOT-22. The initial cohort with hyposmia were also examined at 8 weeks and 6 months after initial examination. Results There were no differences between the SARS-CoV-2-positive cohort without hyposmia and negative controls in terms of BSIT (8.5 ± 2.6 vs. 10.2 ± 1.8), TS (3.4 ± 0.6 vs. 3.9 ± 0.3) or VAS (2.1 ± 1.3 vs. 1.1 ± 0.5); yet the SNOT-22 was significantly elevated (27.7 ± 11.2 vs. 16.4 ± 10.8). The SARS-CoV-2-positive group with hyposmia performed significantly poorer in BSIT (4.0 ± 1.7 vs. 8.5 ± 2.6/10.2 ± 1.8), TS (2.6 ± 1.3 vs. 3.4 ± 0.6/3.9 ± 0.3), and VAS (7.9 ± 2.2 vs. 2.1 ± 1.3/1.1 ± 0.5) compared to both control groups. At week 8 and month 6 control, six and five patients, respectively, still suffered from subjectively and objectively impaired chemosensory function. The other patients had recovered in both respects. Conclusion SARS-CoV-2 patients with subjectively impaired chemosensory function regularly perform poorly in objective measurements. About 70% of patients suffering from olfactory dysfunction in SARS-CoV-2 quickly recover—the rest still suffers from considerable impairment 6 months after infection.

Pubmed PDF Web

A survey of vocal health in church choir singers

V Sharma,S Nayak,U Devadas

Publication date 10-04-2021


Purpose Choir singing is an important tradition of Christian worship across India. However, vocal health issues related to the church choir singers are less addressed in the literature. Hence, this study aimed to investigate the prevalence of vocal symptoms, identify the variables associated with increased risk of voice problems and knowledge of factors influencing vocal health in church choir singers. Method One hundred and forty-eight church choir singers (61 males and 85 females) between the age range of 18 and 70 years participated in the study. They completed a self-reported questionnaire addressing demographic and singing-related details, vocal symptoms, variables associated with increased risk reporting voice problems and knowledge about factors influencing vocal health. Result Eighty-four percent of the choir singers reported two or more vocal symptoms sometimes or more frequently while or after singing. More than half of the church choir singers had experienced vocal symptoms such as accessing notes in the upper range, loss of vocal endurance, pitch breaks, hoarseness, dryness in the throat, and discomfort in the throat. Among the different variables, systemic hydration found to have a significant association with reporting of voice problems in church choir singers. The overall knowledge regarding the factors influencing vocal health was found to be limited among the choir singers. Conclusion Choir singers like other professional singers experienced a higher prevalence of vocal symptoms during or after singing and exhibited limited knowledge about factors that negatively influence vocal health. Hence, there is a need to look into these singer’s vocal requirements, who usually go unnoticed.

Pubmed PDF Web

Prognostic value of systemic ımmune ınflammation ındex in patients with laryngeal cancer

E Atasever Akkas,B Yucel

Publication date 09-04-2021


Purpose This study aimed to investigate the relationship between the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII) with the clinical and pathological parameters of 118 laryngeal cancer patients, as well as their effects on the survival of the disease. Methods For the calculation of SII, PLR, and NLR, hemogram tests were conducted before treatment. Receiver-operating characteristic (ROC) analysis was used to calculate the cut-off value of SII, NLR, and PLR for overall survival (OS) and disease-free survival (DFS). Results A statistically significant relationship was found between SII and lymphovascular invasion and between NLR and local recurrence, and lymphovascular invasion. In a univariate analysis, SII (p < 0.001) and NLR (p = 0.001) for OS and SII (p < 0.001), PLR (p = 0.043), and NLR (p < 0.001) for DFS were detected as prognostic factors. In a multivariate analysis for OS, SII (HR = 10.54, 95% CI 1.28–86.77; p = 0.029) and extracapsular extension (HR = 3.08, 95% CI 1.15–8.21; p = 0.024) were identified as independent prognostic factors. In a multivariate analysis for DFS, only an extracapsular extension presence (HR = 3.32, 95% CI 1.37–8.08; p = 0.008) was detected as an independent prognostic factor. Conclusion In laryngeal cancer, high SII values were determined as poor independent prognostic factors for OS. High SII, NLR, and PRL have been identified as poor prognostic factors in DFS. A correlation was found between NLR and local recurrence, and lymphovascular invasion and between SII with lymphovascular invasion positivity.

Pubmed PDF Web

Response to comments to “Open versus percutaneous tracheostomy in COVID-19: a multicentre comparison and recommendationfor future resource utilisation”

A Rovira,S Tricklebank,P Surda,S Whebell,J Zhang,A Takhar,E Yeung,K Fan,I Ahmed,P Hopkins,D Dawson,J Ball,R Kumar,W Khaliq,R Simo,A Arora

Publication date 08-04-2021


Pubmed PDF Web

Evaluation of hearing preservation in adults with a slim perimodiolar electrode

S Ludwig,N Riemann,S Hans,F Christov,JM Ludwig,J Saxe,D Arweiler-Harbeck

Publication date 08-04-2021


Purpose Numerous endeavors have been undertaken to preserve hearing in cochlear implant (CI) patients. Particularly, optimization of electrode array design aims at preservation of residual hearing (RH). This study examines whether a slim perimodiolar (PM) electrode array could bear the capability to preserve hearing. Methods A total of 47 patients underwent cochlear implantation receiving the PM electrode. (i) Patients with pure tone audiogram (PTA) thresholds better than 85 dB and/or hearing loss for Freiburg speech test numbers less than 60 dB and more than 50% maximum monosyllabic understanding were assigned to the RH group (n = 17), while all others belonged to the noRH group (n = 30). (ii) Another group implanted with a slim straight, lateral wall (LW) electrode was recruited for comparison. Results We compared 17 RH–30 noRH patients all receiving the PM electrode. RH in PM recipients decreased faster than in LW recipients. No significant differences were observed between both (RH v/s noRH) groups in NRT thresholds, Freiburg speech test and A§E® phonemes. Analogous satisfaction levels were indicated through the questionnaires in terms of sound quality, hearing in silence, noise and directional hearing in both groups. Conclusions The results suggest that hearing preservation is influenced not only by electrode shape but various factors. This study opens an avenue for further investigations to elucidate and enumerate the causes for progressive hearing loss.

Pubmed PDF Web

Management of facial nerve schwannoma: when is the timing for surgery

YS Cho,JE Choi,JH Lim,YS Cho

Publication date 08-04-2021


Purpose Although the estimated prevalence is extremely low, facial nerve schwannoma (FNS) is the most common primary tumor of the facial nerve (FN). In the present study, the outcome of surgical management in 18 patients with FNS was analyzed and an appropriate time for surgery was proposed. Materials and methods A total of 18 patients with FNS who underwent surgical management by a single surgeon from 1999 to 2018 were retrospectively analyzed. Results Among the 18 patients, five had no facial paralysis before surgery. Near-total removal was performed in three cases, and two cases were managed with decompression. In 13 cases with various degree of preoperative facial palsy, nerve continuity was lost during surgery. FN was reconstructed using cable graft in ten cases, direct anastomosis in one case, and facial-hypoglossal nerve transfer in one case. Facial reanimation surgery without FN reconstruction was performed in one case due to a long-standing facial paralysis before surgery. Preoperative House-Brackmann (H-B) grade in all patients was significantly worse as tumor size increased. The correlation was not observed between the duration and severity of preoperative facial palsy. Analysis of 12 patients who underwent FN reconstruction revealed that all patients with good preoperative facial function (H-B grade II–III) recovered to H-B grade III after surgery (7/7, 100%). However, patients with poor preoperative facial function (H-B grade IV or worse) had only a 40% (2/5) chance of improving to grade III after surgery. Preoperative tumor size and duration of facial palsy did not affect postoperative final facial function. Conclusion We suggest that H-B grade III facial palsy is the best time for surgical intervention, regardless of the tumor size or duration of facial palsy.

Pubmed PDF Web

Novel predictive tools and therapeutic strategies for patients with initially diagnosed glottic cancer in the United States

GJ Huang,BB Yang

Publication date 05-04-2021


Objective The objective of this study is to identify valuable prognostic factors, build clinical prediction nomograms, and recommend the optimal therapeutic strategy for patients with initially diagnosed glottic cancer. Methods Patients were extracted from the SEER database. Cox regression analyses, survival analyses, an internal validation, the propensity score analysis, and the competing risk analysis were performed. Results Nine overlapped factors were considered as valuable prognostic factors. Furthermore, nomograms were established for clinical prediction models to assess the 1-, 3-, and 5-year overall survival (OS) and cancer-specific survival (CSS). C-indexes, receiver operating characteristic curves, calibration curves, and decision curve analyses proved that nomograms showed better predictive accuracy, ability, and prognostic value compared to the American Joint Committee on Cancer stage. For patients in stage I, primary site surgery alone would acquire best OS and CSS. For patients in stage II, primary site surgery and/or radiation would gain better OS and CSS. For patients in stage III, radiation plus chemotherapy or primary site surgery (alone or plus radiation) would acquire better OS and CSS. Moreover, for patients in stage IV, primary site surgery plus radiation would gain better OS and CSS. Conclusions Nomograms could be useful for patients’ counseling and guide therapeutic decision-making. Primary site surgery alone may likely be the optimal therapy for stage I glottic cancer, and primary site surgery and/or radiation may be the recommended therapy for stage II glottic cancer. The combination treatment would be the preferred choice for advanced-stage (stage III & IV) glottic cancer, and the role of chemotherapy needs to be further explored.

Pubmed PDF Web

Ferroptosis-related genes for predicting prognosis of patients with laryngeal squamous cell carcinoma

F Han,W Li,T Chen,Y Yao,J Li,D Wang,Z Wang

Publication date 05-04-2021


Background Previous studies reported that ferroptosis-related genes can regulate the process of tumor cell changes by regulating iron metabolism. However, the prognostic value of ferroptosis-related genes in LC remains to be further elucidated. Methods Ferroptosis-related gene expression profiles of coexisting ferroptosis-related genes were extracted from both cohorts (TCGA and GSE27020) for eligible analysis. LASSO Cox regression was utilized to build an optimum ferroptosis-related prognostic model. Kaplan–Meier curve was performed by log‐rank test, and time‐dependent ROC curve was constructed to evaluate the predictive power of this signature in both cohorts. GO and KEGG enrichment analysis was used to investigate the potential mechanism of differential enrichment signal pathways. Results 112 LC patients from the TCGA cohort and 108 LC patients with clinical information from the GEO cohorts were eventually included in the study. Three ferroptosis-related genes were identified as an independent risk factor to establish the prognostic risk score. Kaplan–Meier curve represented that patients with high-risk group favors with worse OS than their low-risk group (P = 0.04). The good performance of the gene signature for predicting OS was evaluated by area under the curve (AUC) of time-dependent ROC curves achieved 0.74 at 3 years, and 0.70 at 5 years. Similar performance has been proved in the external validation cohort. GO and KEGG enrichment analysis have been performed to explore the signaling pathways and underlying mechanisms were significantly active in LC patients. Conclusion In summary, our study developed a ferroptosis-related model that could be an effective biomarker to predict the prognosis of laryngeal cancer.

Pubmed PDF Web

Alteration of the risk of pre-oral cancer and cancer in North Indian population by NAT1 and NAT2 polymorphisms genotypes and haplotypes

K Nigam,S Gupta,OP Gupta,RK Srivastav,SP Singh,S Sanyal

Publication date 04-04-2021


Purpose The risk of oral cancer is strongly related to consumption of tobacco, smoking and drinking alcohol. N-acetyl transferases 1,2 are phase II metabolic enzymes, metabolize aryl and heterocyclic amines which are present in tobacco. NAT2 slows acetylator phenotype and the genotype is related to reduced ability to detoxify these xenobiotic that are carcinogenic to tissues. The aim of our study to determine the risk of oral cancer as well as oral precancerous lesions in North Indian population with polymorphisms in these two N-acetyl transferases 1,2 genes. Materials and methods A total of 250 patients with pre oral cancer, oral cancer and 250 healthy volunteers were genotypes for the NAT1 and NAT2 gene polymorphisms. Genotypes were identified by PCR and RFLP. Genotype frequencies were evaluated by Chi-square test and risk of disease was estimated by Odds ratio (OR) with 95% confidence interval. Result Our results showed that individuals with CT and TT genotypes of NAT1 C > T polymorphism were significantly lower risk of oral diseases (p value = 0.02, OR = 0.60 and p value = 0.04, OR = 0.58, respectively). For NAT2 C > T polymorphism, the TT genotype significantly increased the risk of OSMF (Oral Sub mucous Fibrosis) and Leukoplakia (p value = 0.001, OR = 4.16; p value = 0.002, OR = 4.38, respectively). In contrary, the CC genotype for NAT2 T > C polymorphism increased the risk of OSMF (p value = 0.01, OR = 3.00, 95% CI = 1.31–6.86). Conclusion Our study concludes that the NAT1 polymorphism shows protective association with oral diseases and NAT2 polymorphism and haplotypes also influence the susceptibility to oral diseases in North Indian population subjects.

Pubmed PDF Web

"Authors reply to Letter to the Editor: “Five-year results of vocal fold augmentation using autologous fat or calcium hydroxylapatite”"

K Zeleník,M Formánek,R Walderová,D Formánková,P Komínek

Publication date 03-04-2021


Pubmed PDF Web

A retrospective review of cochlear implant revision surgery: a 24-year experience in China

J Chen,B Chen,Y Shi,Y Li

Publication date 03-04-2021


Purpose We aimed to analyse the reasons behind the need for cochlear implant revision surgeries, as well as the rate at which they occur, to reduce the revision surgery rate for non-device failures. We also aimed to elucidate the cumulative survival and device survival rates in different age groups. Methods This retrospective single cohort study reviewed 4563 cochlear implant surgeries and 119 revision surgeries performed at a tertiary referral hospital in China between 1996 and 2019. Kaplan–Meier curves were used to calculate the cumulative survival and device survival rates. Results The revision surgery rate was 2.61%. The reasons for revision included device (73.1%) and non-device (26.9%) failures. The most common reasons were hard device (47.1%) and non-device failure (28.6%). The 10- and 20-year cumulative survival rates were 96.8% and 96.7%, respectively. Younger children were more likely to undergo a second surgery. Conclusion This study is the longest study about revision surgery in China. Cochlear implantation is a reliable treatment. It has a low complication rate in patients with sensorineural hearing loss. Children have a higher revision rate than adults. Doctors should be aware of each complication and perform the appropriate procedure.

Pubmed PDF Web

Development of a diagnostic model to identify patients at high risk for cerebellopontine angle lesions

M Hentschel,M Rovers,S Steens,G Hannink,H Kunst

Publication date 03-04-2021


Purpose To develop a diagnostic model to identify patients at high risk of a CPA lesion. Methods A consecutive cohort of patients with AAD referred by a general practitioner, who underwent their first MRI examination of the CPA between 2005 and 2015 was included. Demographics, symptoms, findings during physical examination, and pure-tone audiometry were used as potential predictors. The presence of a CPA lesion was used as outcome. Results We analyzed data of 2,214 patients, detecting 73 CPA lesions in 69 (3.1%) patients. The final model contained eleven variables, namely gender male OR 1.055 (95% CI 0.885–1.905), sudden onset of hearing loss OR 0.768 (95% CI 0.318–0.992), gradual onset of hearing loss OR 1.069 (95% CI 0.500–1.450), unilateral tinnitus OR 0.682 (95% CI 0.374–0.999), complaints of unilateral aural fullness OR 1.006 (95% CI 0.783–2.155), instability OR 1.006 (95% CI 0.580–2.121), headache OR 0.959 (95% CI 0.059–1.090), facial numbness OR 2.746 (95% CI 0.548–11.085), facial nerve dysfunction during physical examination OR 1.024 (95% CI 0.280–3.702), and asymmetry in BC at 1 k Hz OR 1.013 (95% CI 1.000–1.027) and 4 k Hz OR 1.008 (95% CI 1.000–1.026). Conclusion The proposed diagnostic model is a first step in selecting patients with a high risk of a CPA lesion among those with AAD. It needs to be externally validated prior to its implementation in clinical practice.

Pubmed PDF Web

Are the oxidative stress levels in the tumor center and tumor boundary different from those in healthy tissue?

R Dogan,EM Guler,A Kocyigit,İ Çelik,E Senturk,A Yenigun,S Tugrul,O Ozturan

Publication date 03-04-2021


Purpose This study aimed to investigate the relationship between oxidative stress levels in the tumor center, tumor edge, and healthy tissue. Methods This study included a total of 53 patients with head and neck cancer. Samples of 5 × 5 × 5 mm were collected from the tumor center, tumor edge, and the healthy tissue. Total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values were evaluated. (1) Oxidative stress values in the center and edge of all tumors and in healthy tissues were compared according to localization. (2) Tumors were divided into two groups as malignant (Group 1 n = 28: Laryngeal and tongue squamous cell cancers) and benign (Group 2 n = 25: Pleomorphic adenoma and Warthin tumors). The groups were compared according to the localization of the tissues. Results The TOS value in the tumor edge was significantly higher than those in the tumor center and the healthy tissue. The TAS value in tissue located in the tumor edge was significantly higher than in the healthy tissue. The OSI value in the tumor edge was significantly higher than those in the tumor center and the healthy tissue. In all three localizations (tumor center, tumor edge, and healthy tissue), TOS and OSI values in Group 1 were significantly higher than Group 2. Conclusion Oxidative stress values in the tumor edge are significantly higher than the center of the tumor and healthy tissue. In malignant tumors, oxidative stress values are significantly higher in all localizations compared to benign tumors.

Pubmed PDF Web

Treatment success after rhinosurgery: an evaluation of subjective and objective parameters

MM Martin,K Hauck,A von Witzleben,J Lindemann,MO Scheithauer,TK Hoffmann,F Sommer

Publication date 03-04-2021


Purpose Septal deviation and nose deformities are widely prevalent. As a consequence, patients may complain about difficulties in nasal breathing leading to a perception of diminished disease-specific quality of life. In a prospective randomized trial, we aimed to analyse the outcome of septoplasty (SPL) and septorhinoplasty (SRP) on patient satisfaction. Methods Patients with functional indication for SPL (n = 19) or SRP (n = 54) were included and randomized for additional turbinoplasty. Preoperative clinical symptoms were collected with SNOT-20 GAV (Sinu-nasal outcome test-20—German adapted version) and NOSE© (nasal obstruction symptom evaluation) questionnaires. The final evaluation of treatment success was performed 9 months after surgery with SNOT-20 GAV, NOSE© and a self-established feedback questionnaire. Nasal breathing and obstruction were objectively measured with rhinomanometry and acoustic rhinometry minimum cross-sectional area 2 (MCA2). Results Minimum cross-sectional area 2 was statistically improved compared to the pre-treatment value in SPL (p = 0.0004) and SRP (p = 0.0001). Regarding MCA2 values of matched patient groups, similar findings were detected (SPL: p = 0.0013, SRP: p < 0.0001). Sinu-nasal outcome test-20 GAV and NOSE© scores were significantly reduced after both surgical procedures (NOSE©: SPL: p < 0.0001, SRP: p < 0.0001; SNOT-20 GAV: SPL: p = 0.0068, SRP: p < 0.0001). Evaluation of patient satisfaction in a self-established feedback questionnaire revealed a motivation of 81% of patients to redo the surgery (SPL 13/16, SRP 34/42) and a notably general satisfaction of 86% for SPL and 80% for SRP. Conclusion Rhinosurgery leads to quantitative better nasal breathing and increased disease-specific satisfaction. However, this study implies the importance of the right selection of patients and the correct indication of the surgical technique.

Pubmed PDF Web

Letter to the Editor regarding article: “Endoscopic surgical treatment for rhinogenic contact point headache: systematic review and meta-analysis”

M Straburzyński

Publication date 02-04-2021


Pubmed PDF Web

Long-term stability of results following surgery for obstructive sleep apnea (OSA)

P Martínez-Ruíz de Apodaca,M Carrasco-Llatas,S Matarredona-Quiles,M Valenzuela-Gras,J Dalmau-Galofre

Publication date 02-04-2021


Purpose Although upper airway surgery in selected patients with obstructive sleep apnea (OSA) has been shown to be beneficial, its long-term effects have been questioned. The main objective was to evaluate whether results following surgery remain stable over time, both in objective and subjective terms. As a secondary aim, such stability was also measured in relation with the type of surgery performed.
Methods This work constitutes a retrospective study of OSA adult patients subjected to the following surgical procedures: different types of pharyngoplasties, tongue-base surgery, partial epiglottectomy or hyoid suspension. Those who exclusively underwent tonsillectomy or nasal surgery were excluded. Before surgery, a sleep study, and an assessment of the patients’ sleepiness and quality of life were performed, which were repeated at 8, 34, and 48 months after surgery. A total of 153 patients was included. Results Following surgery, the apnea–hypopnea index decreased from 34.84/h to 14.54/h and did not vary more than one point in subsequent controls (p = 0.01). The oxygen desaturation index changed from 31.02/h to 14.0/h and remained stable in the second (15.34/h) and third (11.43/h) controls (p = 0.01). Parameters measuring sleepiness and well-being demonstrated the maintenance of long-term benefits. New pharyngoplasties were observed to be more stable than classic pharyngoplasties in the long term (p = 0.04). Single-level surgeries were found to be more stable than multilevel surgeries, although a statistically significant difference was not observed (p = 0.07). Conclusion The benefits obtained remained stable in the long term. In our sample, modern pharyngoplasty techniques showed superiority over the classic ones regarding long-term stability.

Pubmed PDF Web

Modified adenoid grading system for evaluating adenoid size in children: a prospective validation study

H Liu,X Feng,Y Sun,Y Fan,J Zhang

Publication date 02-04-2021


Nasal endoscopy is the best choice for evaluation of adenoid size, but very few studies published on the endoscopic quantitative assessment. This study aimed to newly propose and validate a modified adenoid grading system (MAGS) with the existing endoscopic scoring methods of adenoid size. A prospective study on children with chronic mouth breathing and having endoscopic nasal examination was conducted. Digital images obtained during endoscopic examination were evaluated with the traditional method and the MGAS. Adenoid size was also evaluated by intraoperative nasal endoscopy among those underwent adenoidectomy. One hundred and thirty patients were enrolled. The MAGS showed high inter-rater reliability with a Kappa score of 0.869. Sixty of 130 patients underwent adenoidectomy and assessed with intraoperative nasal endoscopy. The MAGS significantly correlated to the percentage of nasopharyngeal obstruction of intraoperative endoscopy (Spearmans r = 0.796, gamma coefficient = 0.94), and the percentage of choanal obstruction of preoperative endoscopy (Spearmans r = 0.816, gamma coefficient = 0.859). Our findings suggest that the MAGS has high reliability and validity for assessment of adenoid size. It may be a more suitable and reliable grading system for endoscopic evaluation of adenoid size.

Pubmed PDF Web

Copyright © KNO-T, 2020 | R/Abma