ORL 2022-05-23

Lymph Node Tuberculosis in Otolaryngological Practice: A Study of 68 Cases at the Sourô Sanou University Hospital of Bobo Dioulasso, Burkina Faso

Publication date 23-05-2022

Introduction: Lymph node tuberculosis (LNTB) frequently affects peripheral cervical lymph node body sites. We aimed to study epidemiology and diagnostic and therapeutic characteristics of LNTB patients in ENT routine practice.
Methods: We conducted a cross-sectional prospective study in the ENT and cervicofacial surgery department at the Sourô Sanou University Hospital of Bobo Dioulasso, Burkina Faso, for a period of 36 months.
Results: There were 68 cases with LNTB, of which 54.4% were mostly men. The mean age and the median age were calculated at 37 ± 6.8 and 42 years, respectively. The patient’s age ranged between 3 and 81 years, and the most represented age group was from 30 to 60 years (62%). According to geographical origin, most patients (79%) originated from rural areas. In 6 cases (9%), patients reported diabetes and 12 patients were HIV positives (18%). Most clinical features leading to the ENT consultation were cervical lymph nodes (82%) and cervical scrofuloderma (18%). For the multiple locations, the lymphadenopathies involved mostly the transversal cervical chain (56%) and spinal chain (50%). Histopathology examination was the mostly diagnosed methods used in 68%. A 6-month anti-tuberculous treatment was given with a follow-up of 6 months without any relapse in 62 cases (97%).
Conclusion: The frequency of 68 cases of LNTB in 3 years is underappreciated. Among all lymph node sites, transversal cervical chain and cervical spinal chain were mostly affected. Further advanced studies are recommended to determine the prevalence and contributing factors of LNTB in the study area. ORL

Pubmed PDF Web

Cochlear Implantation in a Patient with Neurofibromatosis Type 2 and an Intracochlear Schwannoma: A Case Report and Literature Review

D Zhang,Z Fu,S Han,F Guo,N Tang,Y Zhao,G Guan

Publication date 10-05-2022

A primary intracochlear schwannoma (ICS) is a unique type of vestibular schwannoma (VS); the tumor originates from the terminal branches of the cochlear nerve and is confined to the cochlea. An ICS is the most common subtype of schwannoma in the inner ear. As an ICS is clinically rare, diagnosis and treatment remain challenging. We report a rare case of cochlear implantation (CI) in a patient with neurofibromatosis type 2 and an ICS. The patient exhibited bilateral, profound, sensorineural hearing loss. The tumor on one side was a common VS treated via tumor and acoustic nerve resection and that on the other side an ICS. To ensure auditory rehabilitation via CI, we performed CI while removing part of the ICS via an enlarged round window. Auditory rehabilitation was satisfactory. Thus, ICS patients, especially those who urgently require auditory rehabilitation, can undergo simultaneous CI and (total or partial) tumor removal. However, the long-term results require close observation. ORL

Pubmed PDF Web

Nasal Mucociliary Clearance and Sinonasal Symptoms in Healthcare Professionals Wearing FFP3 Respirators: A Prospective Cross-Sectional Study

S Yildiz,A Yankuncu,S Zer Toros,Ç Tepe Karaca

Publication date 02-05-2022

Introduction: The purpose of the present study was to assess nasal mucociliary clearance (NMC) and sinonasal symptoms of healthcare professionals wearing filtering facepiece-3 (FFP3) respirators.
Methods: This prospective cross-sectional study was conducted at a large tertiary care academic center. Thirty-four healthcare professionals working at a coronavirus disease-19 patient care unit were included in the study. Visual analog scale (VAS) scores of sinonasal symptoms (nasal discharge, postnasal discharge, nasal blockage, hyposmia, facial pain/pressure, facial fullness, headache, fatigue, halitosis, cough) and the NMC times of the participants were assessed immediately before wearing FFP3 respirators and after 4 h of work with FFP3 respirators.
Results: The mean age of the participants was 28.82 ± 4.95 (range, 26–31) years. Twenty participants were female and 14 were male. After wearing the FFP3 respirators for 4 h, a statistically significant increase was observed in total VAS scores for all sinonasal symptoms and NMC times (p #x3c; 0.001). When the VAS score of each sinonasal symptom was evaluated separately, a statistically significant increase was found for VAS scores of nasal discharge, postnasal discharge, nasal blockage, hyposmia, facial pain/pressure, and facial fullness (p #x3c; 0.05).
Conclusion: The present study shows that nasal mucosal functions might be affected significantly after 4 h of using FFP3 respirators. The long-term effects and clinical significance of these short-term changes should be investigated on healthcare professionals in further studies. ORL

Pubmed PDF Web

Effect of Local Corticosteroid Administration on CD8+CD25+Foxp3+ Tregs in Neutrophilic CRSwNP

L Lin,J Lan,F Dai,J Wei,Z Chen

Publication date 25-04-2022

Introduction: CD8+CD25+Foxp3+ regulatory T cells (Tregs) play an important role in human’s immune tolerance. The study was aimed to assess the influence of budesonide nasal spray on CD8+CD25+Foxp3+ Tregs and to evaluate their cellular functions in neutrophilic chronic rhinosinusitis with nasal polyps (CRSwNPs).
Methods: Fifteen patients with neutrophilic CRSwNPs were enrolled and received physiological saline or budesonide nasal spray treatment (Saline or Budesonide group) for 3 months. Nasal tissue samples were obtained from normal subjects or those patients and cultured in vitro. CD8+CD25+Foxp3+ Tregs were separated from normal or NP tissues and also cultured in vitro. Then interleukin (IL)-10 and its mRNA were evaluated in the above cell cultures. The cells were applied into NP cultures. Finally, myeloperoxidase (MPO), interferon (IFN)-γ, IL-1β, and tumor necrosis factor (TNF)-α were assessed in the tissue cultures.
Results: CD8+CD25+Foxp3+ Tregs decreased in NP tissues. Budesonide administration did not enhance the percentage of these cells in polypoid tissues. IL-10 and its mRNA were increased in the above cell cultures from NPs. However, there were no statistical differences between the two treatments in the IL-10 expression. Additionally, levels of MPO, IFN-γ, IL-1β, and TNF-α were totally elevated in NP tissue cultures and reduced after the administration of CD8+CD25+Foxp3+ Tregs. However, there were no significant differences in concentrations of these mediators between these two groups of the CD8+CD25+Foxp3+ Tregs treatment in vitro.
Conclusion: The findings indicate that CD8+CD25+Foxp3+ Tregs might regulate the neutrophilic inflammation, and budesonide nasal spray therapy could not ameliorate the inflammation in neutrophilic CRSwNPs. ORL

Pubmed PDF Web

Impact of COVID-19-Mediated Olfactory Loss on Quality of Life

MS Otte,A Haehner,ML Bork,JP Klussmann,JC Luers,T Hummel

Publication date 12-04-2022

Introduction: COVID-19 can be associated with a variety of longer-lasting impairments that can have a significant impact on patients’ quality of life (QoL). While this is well described in the literature for limitations in lung capacity or permanent headaches, there is little research on the impact of olfactory dysfunction in the context of COVID-19 on patients’ QoL.
Methods: In 65 patients with a history of COVID-19, the present olfactory ability was assessed using the Sniffin’ Sticks test. In addition, olfactory QoL was assessed by the Questionnaire of Olfactory Disorders. Self-assessment was performed with visual analogue scales. The data were compared with the results obtained in healthy individuals and in patients with hyposmia due to other viral infections.
Results: The QoL of COVID-19 patients was significantly lower compared to the healthy control group. Even recovered subjects whose olfaction had already returned to the normal range still had a reduced QoL. The severity of the olfactory impairment correlated with the reduction in QoL. However, the olfactory QoL of COVID-19 patients was not worse than that of patients’ olfactory loss due to other viral infections. Patients with parosmia had reduced QoL and rated their situation worse than patients without parosmia.
Conclusion: QoL appears to be impaired in patients with long-lasting COVID-19 olfactory disorders several months after overcoming acute symptoms, even if olfaction has normalized. However, the impairment is not more pronounced than in patients with other postviral olfactory disorders of the same duration. ORL

Pubmed PDF Web

Effects of Nasal Airflow-Inducing Maneuver in Total Laryngectomy Patients Based on Changes to Olfactory Test Results: A Retrospective Study

Y Ishikawa,M Suzuki,Y Yanagi,U Konomi

Publication date 01-04-2022

Introduction: This study aims to retrospectively examine temporal changes in three aspects, i.e., olfactory threshold test, olfactory identification test, and olfactory perception on daily living test, caused by the use of the nasal airflow-inducing maneuver (NAIM).
Methods: The olfactory threshold test (Sniffin’ Sticks test), olfactory identification test (Open Essence OE), and olfactory perception on daily living test (self-administered odor question; SAOQ) were administered to 46 patients who had undergone a total laryngectomy (NAIM Start group: 17; Using group: 19; and Nonuse group: 10). The tests were immediately performed after the NAIM and again after an average of 8 months.
Results: In the NAIM Start group, all olfactory functions significantly improved in the second test compared with the first test (Sniffin’ Sticks test and OE, p #x3c; 0.01 for both; self-administered, p #x3c; 0.05). Additionally, in terms of the intergroup changes among scores for the Sniffin’ Sticks test and OE, the NAIM Start group showed a significant difference compared with all of the other groups (Start group #x3e; Using and Nonuse group, p #x3c; 0.01). The NAIM Using group did not exhibit any significant changes. In the NAIM Nonuse group, olfactory identification function was lower in the second test compared with the first test and showed a trend toward a significant difference (OE, p #x3c; 0.1). Temporal changes in SAOQ showed a significant increase in all intragroup comparisons. However, there were no significant differences observed in terms of the changes between the groups.
Conclusion: The results demonstrated that even in those who were not using NAIM and undergoing olfactory rehabilitation after laryngectomy (NAIM Start group), the subsequent daily use of NAIM and voluntary rehabilitation aided in the recovery of olfactory function to the same level as that in the already using NAIM group. SAOQ results were considered because of the experimenter effect and they appeared to be unrelated to use NAIM. This study showed that in total laryngectomy patients who did not receive olfactory rehabilitation, olfactory identification was reduced. ORL

Pubmed PDF Web

Olfactory Cleft Width and Volumes in Patients with COVID-19 Anosmia

DE Tekcan Sanli,AN Sanli,SG Kandemirli,A Altundag,D Yıldırım

Publication date 30-03-2022


Pubmed PDF Web

Oncological Outcomes after Pulmonary Metastasectomy for Head and Neck Squamous-Cell Carcinoma and Adenoid Cystic Carcinoma

H Park,S Han,WJ Jeong,YH Jung,MW Sung,SH Ahn

Publication date 28-03-2022

Introduction: Pulmonary metastatic head and neck cancer has a poor prognosis. Pulmonary metastasectomy has been performed but only in carefully selected patients. The aim of this study was to examine the clinical characteristics and oncological follow-up of patients who underwent pulmonary metastasectomy.
Methods: Data of 54 patients with squamous-cell carcinoma (SCC) or adenoid cystic carcinoma (ACC) who underwent metastasectomy between 2003 and 2019 at two tertiary referral centers were retrospectively reviewed.
Results: The 3-year and 5-year disease-free survival rates after metastasectomy were 49.9% and 39.9% for SCC and 38.9% and 32.4% for ACC, respectively. Univariate analysis revealed that a disease-free interval (DFI) less than 14 months and R1 resection (hazard ratio HR 95% confidence interval: 2.95 0.77–5.62, 4.64 0.99–21.65, respectively) were risk factors for recurrence in SCC and that a high T stage (HR: 5.24 1.22–22.58) was a risk factor in ACC. In SCC, a DFI less than 14 months and R1 resection (hazard ratio: 6.35 1.36–29.54, 12.79 1.53–106.95, respectively) were risk factors in a multivariate analysis.
Conclusion: Pulmonary metastasectomy had a fair effect on head and neck SCC and ACC, and the prognosis was better in SCC patients with a DFI greater than 14 months. ORL

Pubmed PDF Web

Olfactory Cleft Width and Volumes, COVID-19, and Anosmia: Correspondence

R Mungmunpuntipantip,V Wiwanitkit

Publication date 11-03-2022


Pubmed PDF Web

A Study on the Effect of 850 nm Low-Level Diode Laser versus Electrical Stimulation in Facial Nerve Regeneration for Patients with Bell’s Palsy

A Shoman,A Hassan,A Kassab

Publication date 08-03-2022

Introduction: Bell’s palsy is acute facial paralysis with unclear etiology that results in weakness of facial muscles or paralysis on one side of the face.
Methods: This prospective, randomized, single-blind, controlled study was conducted on 45 patients with Bell’s palsy who were randomly divided into three equal groups. Two groups received either low-level laser therapy (LLLT) or electrical stimulation (E.
S.) both in conjunction to medications, massage, and facial exercise treatment. The third group (control) was treated with medication, massage, and facial exercise.
Results: The primary outcome was the improvement of nerve conduction velocity of facial nerve while the secondary outcome was the change of Sunnybrook facial grading system (SBGS). The outcome measures were evaluated pre- and posttreatment. There was statistically significant difference between the three groups in favor of the LLLT group regarding the nerve action potential amplitude and latency, in addition to signs of nerve regeneration and improved SBGS.
Conclusion: This short-term investigation revealed that LLLT proved to be more efficient than E.
S. in facial nerve regeneration for patients with Bell’s palsy. ORL

Pubmed PDF Web

Copyright © KNO-T, 2020 | R/Abma