Department Of Otolaryngology Research Articles

Correlation of the Size of Adenoids With Impedance Audiometry Findings.

Introduction Adenoid tissue is part of the first line of immunity of the upper aero-digestive tract. It is located in the postero-superior wall of the nasopharynx behind the choana.Adenoid hypertrophy, a common childhood disorder, significantly contributes to the pathogenesis of otitis media with effusion (OME), which is the leading cause of hearing impairment in young children. This condition can result in delayed speech, poor academic performance, and language development issues. Assessing the size of the adenoids and their correlation with OME is crucial, as undiagnosed cases can lead to complications such as atelectasis of the tympanic membrane and cholesteatoma. Clinical examination of the nose alone is often insufficient, and children do not cooperate for nasal endoscopy. Therefore, a lateral radiograph of the skull is considered the most reliable method for assessing the adenoid size. The size of the adenoids can affect Eustachian tube patency, which is reflected in the results of impedance audiometry. This study aimed to correlate the size of adenoids with impedance audiometry findings. Methods This cross-sectional observational study was conducted in the Department of Otorhinolaryngology of a tertiary care hospital from October 1, 2022, to March 31, 2024. A sample size of 50 patients was taken for the study. The inclusion criterion of selection of the patients included patients aged 3 to 15 years, who suffered from recurrent attacks of upper respiratory tract infections,particularly those with adenoid facies confirmed by X-ray with a non-perforated tympanic membrane. Exclusion criteria encompassed patients below 3 or above 15 years, and those with acute or chronic suppurative otitis media, craniofacial anomalies, or nasal pathologies like polyps.Adenoids were graded using X-ray imaging of the nasopharynx, and correlations between the adenoid size and impedance audiometry findings, such as middle ear pressure and compliance, were analyzed. Results The study assessed the relationship between the adenoid size and impedance audiometry findings, focusing on middle ear pressure and compliance, as well as the occurrence of OME. The results indicated a significant decline in middle ear pressure with increasing adenoid grades. Specifically, adenoid grade 1 had an average pressure of -3.50 daPa, while grade 4 had the lowest average pressure at -119.72 daPa. This trend was statistically significant with a p-value of 0.00042. Similarly, compliance values also decreased with higher adenoid grades. Grade 1 had an average compliance of 0.64 ml, whereas grade 4 had the lowest average compliance at 0.28 ml. This relationship was statistically significant, as indicated by a p-value of 0.0048. Additionally, the analysis showed that a significant majority of patients with enlarged adenoids also presented with OME, highlighting a strong association between adenoid hypertrophy and this condition. Conclusion The study concluded that larger adenoids wereassociated with lower middle ear pressure and reduced compliance. Additionally, a significant majority of patients with enlarged adenoids also had OME. This underscores the importance of evaluating adenoid hypertrophy in the context of OME due to its potential impact on childhood hearing and development.

Frequency of Distant Metastasis of Differentiated Thyroid Carcinoma- A Descriptive Analysis

Introduction: The presence of distant metastases is one of the important predictive factors of poor outcomes in patients with thyroid carcinoma. It is rarely observed at early presentation of differentiated thyroid carcinoma (DTC). This study aimed to analyze the frequency of distant metastasis in differentiated carcinoma of the thyroid. Methods: This cross-sectional observational study was conducted at the Department of Otolaryngology, Rajshahi Medical College Hospital, Rajshahi, and Department of Otolaryngology Bangabandhu Sheikh Mujib Medical University (BSMMU), from July 2011 to Jun 2012. A total of 40 patients were selected as study subjects by simple random sampling technique. A descriptive analysis of data was carried out by using a statistical package for social science (SPSS) 22.0 for Windows. Result: In this study, a majority (35, 87.5%) of the patients suffered from papillary carcinoma, followed by (5,12.5%) follicular carcinoma. Considering the distant metastasis, 2 (5.71%) patients had metastasis to the lung among the patients with papillary carcinoma (n=35). 1 patient had lung metastasis and another 1 patient had bony metastasis among the follicular carcinoma patients. In terms of distant metastasis, 50% of the patients had distant metastasis from each papillary and follicular carcinoma. Conclusion: This study concludes that metastasis in differentiated thyroid carcinoma is not uncommon. Distant metastasis is more common in follicular thyroid carcinoma than papillary carcinoma. Lung and bone metastasis are common regarding the site of metastasis.

Application of bundled process control in the prevention of pressure injury in patients with head and neck cancer.

This study aimed to explore the application effects of cluster process control and routine nursing on the prevention of pressure injury (PI) in patients undergoing head and neck cancer surgery and to provide a basis for reducing the occurrence of PI, thereby promoting the safety of the patients. This was a retrospective study. Patients with head and neck cancers who underwent surgical treatment in the Department of Otolaryngology at the Second Affiliated Hospital of Fujian Medical University from July 2022 to June 2023 were selected as the research participants. Participants were classified into experimental and control groups using a convenience sampling method. In the experimental group, cluster process control was implemented, while routine nursing management was applied in the control group. The incidence of PI (p = 0.028) and healing time (p = 0.035) in the experimental group were lower than those in the control group. The process management ability of nurses in the experimental group was significantly improved, with the results for the Braden scale (p = 0.023), effective decompression (p = 0.002), floating heel (p = 0.002), nutrition monitoring (p = 0.005), and patient satisfaction in the experimental group being higher than those in the control group (p = 0.007). This study effectively demonstrated the effect of cluster process control in reducing the incidence of PI in patients undergoing head and neck cancer surgery, thereby determining that cluster process control is suitable for clinical application.

Minimally invasive management of parapharyngeal space tumors: Introducing a decision-making algorithm and radiologic tool

ObjectiveTraditionally tumors of the parapharyngeal space (PPS) are resected through transcervical approaches. More recent approaches include endoscopic approaches or transoral robotic surgery (TORS) without directions on when to use which approach. Our objective was to find objective parameters to choose the most suitable approach. MethodsIt is a retrospective study containing 6 patients from May 2019 to May 2021 with tumors of the PPS treated in the Department of Otolaryngology and Head-Neck Surgery at the Hospital of Lucerne, Switzerland. ResultsThe data was analysed in average 53 months after surgery. Tumor resection was completed with TORS in 3 patients and endoscopically in 3 patients. Mean operation time was 114 min. No major complications occurred. No evidence of tumor was found in magnetic resonance imaging studies postoperatively in all patients. ConclusionWe conclude that a resection via TORS or endoscopic technique is safe and effective. Furthermore, we postulate that the further a tumor is located in the upper lateral area of the PPS, an approach via TORS is less possible.

Correlation between the distribution of airborne pollen and the positive sIgE test in patients with allergic rhinitis in Taiyuan City in spring from 2022 to 2023

This study was to investigate the relationship between spring pollen distribution concentration, species and the detection results of air-borne pollen allergens in Taiyuan City, Shanxi Province during March to May 2022 and March to May 2023.A retrospective study was conducted in the Otorhinolaryngology Head and Neck Surgery Clinic of the First Hospital of Shanxi Medical University.Pollen particles will be monitored by gravity sedimentation method on the roof of the outpatient department of the First Hospital of Shanxi Medical University in downtown Taiyuan from March to May 2022-2023, and pollen species and quantity will be observed and recorded under an optical microscope.The air-borne pollen allergen detection results of all allergic rhinitis patients in the otolaryngology Head and Neck surgery Department of the First Hospital of Shanxi Medical University were extracted from the relevant outpatient system. SPSS software and Pearson correlation analysis were used to compare the correlation between the allergens and the dominant air-borne pollen monitoring results. Results are as follows: (1)A total of 18 species of spring pollen in Taiyuan City were monitored in 2022-2023, with 101 177.5 grains, and the dominant airborne pollen was poplar (16.69%) and pine (29.06%) pollen. The pollen of poplar (11.96%), elm (7.89%) and cypress (8.68%) were dominant in early spring; Pine (25.16%) pollen predominated in late spring. The two peaks of pollen dispersal in Taiyuan were in late March (15 479 grains) and early and mid May (15 094/15 343 grains).(2) The positive rates of allergens in serum specific IgE detection were: wormwood (46%, 248/541 cases), tree combination (26%, 143/541 cases), ragweed (19%, 101/541 cases), humulus scandens (9%, 49/541 cases).(3)There was a linear positive correlation between the positive rate of air-borne pollen allergens in allergic rhinitis patients in the Department of Otolaryngology Head and Neck Surgery in the First Hospital of Shanxi Medical University and the dominant air-borne pollen concentration in the same period (P<0.05, r=0.999). In conclusion, two spring pollen dispersal peaks were formed in late March and early to mid May in Taiyuan City, and the dominant air-borne pollens were poplar and pine pollens. The positive rate of air borne pollen allergen sIgE showed that wormwood allergy was the highest.There was a positive correlation between the concentration of air-borne pollen and the positive rate of air-borne pollen allergens in patients with allergic rhinitis in the Department of otorhinolaryngology and head and neck surgery in Taiyuan in 2022 and 2023.The monitoring of pollen distribution in spring can provide an important scientific basis for clinical workers to formulate prevention and treatment plans for patients with allergic rhinitis in the season, and provide data reference for the epidemiological investigation of allergic diseases in Taiyuan in the future.

Comparison of the post-operative outcomes between different surgical techniques for inferior turbinate reduction surgery: A cross sectional study.

To compare and measure post-operative outcomes among various surgical techniques for reducing inferior turbinate hypertrophy (ITH), and to identify the factors associated with the clinical outcomes of turbinoplasty in patients with this condition. A cross-sectional study was carried out from January 2021 to December 2022 at the Otorhinolaryngology Department of King Abdulaziz Medical City in Riyadh, Saudi Arabia. A total of 301 adult patients with ITH were included and were divided into different groups. Postoperative follow-up assessments were completed after one week, one month, and 6 months to evaluate outcomes and complications associated with each surgical technique; descriptive analysis, cross-tabulation, and exact logistic regression were utilized as data analysis methods. Most patients in both groups experienced partial or complete improvement after surgery, with 92% showing positive outcomes. Common clinical signs included deviated nasal septum deviation and external nasal deformity, while nasal obstruction was most frequently reported as the primary symptom. Post-surgery bleeding occurred in 3.7% of cases; no adhesions were noted. Microdebrider, medial flap, out-fracture, and submucosal diathermy techniques all demonstrated significantly higher improvement rates than others. The identified techniques with higher improvement rates offer evidence-based guidance for selecting optimal surgical approaches, while the study's limitations warrant further prospective research to validate these findings. Ultimately, it contributes valuable knowledge to the field of otorhinolaryngology, aiming to enhance patient outcomes and improve the management of ITH worldwide.

Nodal Yield in Level II-IV Neck Dissections in Head and Neck Squamous Cell Carcinoma.

The main objective of this study is to analyze factors associated with nodal yield in level II-IV selective neck dissections (NDs) and the secondary objective is to assess its impact on overall and disease-free survival. Observational retrospective study including adult patients submitted to level II-IV ND from January 2015 to December 2021 in the otorhinolaryngology department of a tertiary hospital center. A total of 44 patients and 78 level II-IV NDs (34 bilateral and 10 unilateral) were included. The median age at diagnosis was 60(22-74) years, and 93.2% of the patients were male. A lower nodal yield was significantly associated with previous radiotherapy (p = 0.042) and extranodal invasion (p < 0.001) and was non-significantly associated with older age (p = 0.065). Furthermore, on a Cox analysis adjusted to the cN status and age, the nodal yield was not associated with five-year disease-free survival (HR = 0.986; 95% CI = 0.922-1.054; p = 0.681) nor with five-year overall survival (HR = 1.006; 95% CI = 0.925-1.095; p = 0.888). A reduced nodal yield in level II-IV NDs was significantly associated with previous radiotherapy and extranodal extension and non-significantly associated with age. There was no association between the nodal yield and five-year overall survival or disease-free survival.

Association of Residual Low-frequency Hearing Loss in Children and Type of Ventilation Tube Placed During Myringotomy With Tympanostomy Tube Placement

Objective: Assess whether titanium Tytan tympanostomy tubes result in a larger air-bone gap (ABG) at lower frequencies compared to Armstrong and Paparella tubes. Study Design: Retrospective cohort study. Setting: Pediatric otolaryngology department of a 1000-bed academic center. Patients: A cohort of 110 children, aged 4–16 years, who had no sensorineural hearing loss or congenital syndromes and underwent tympanostomy tube placement between August 2018 and February 2021. Interventions: Tympanostomy procedures using Tytan, Armstrong, or Paparella tubes. Main Outcome Measure: Evaluation of pure tone average (PTA) and ABG at frequencies of 500 and 250 Hz. Results: Tytan tubes enhanced PTA and ABGs across studied frequencies. Nonetheless, post-Tytan tube placement exhibited significantly worse PTA and 500 Hz ABG compared to Armstrong and Paparella tubes (P &lt; 0.05; P &lt; 0.0001). Additionally, 250 Hz ABG post-Tytan was inferior to post-Armstrong (P &lt; 0.0001). Relative risks of persistent ABG ≥ 15 dB with Tytan versus Armstrong tubes were 2.36 (1.62–3.44) at 500 Hz and 1.49 (1.09–1.99) at 250 Hz. Against Paparella tubes, these were 2.11 (1.28–3.72) at 500 Hz and 1.12 (0.81–1.67) at 250 Hz, the latter being not significant. Conclusion: While Tytan tubes optimize PTA, they are linked to enduring ABG ≥ 15 dB at lower frequencies. Notably, they perform less favorably in terms of 500 Hz PTA and ABG compared to both Armstrong and Paparella and demonstrate poorer 250 Hz ABG when juxtaposed with Armstrong tubes.

MiR-107 Targets NSG1 to Regulate Hypopharyngeal Squamous Cell Carcinoma Progression through ERK Pathway.

Hypopharyngeal squamous cell carcinoma (HSCC) is a kind of malignant tumor with a poor prognosis and low quality of life in the otolaryngology department. It has been found that microRNA (miRNA) plays an important role in the occurrence and development of various tumors. This study found that the expression level of miRNA-107 (miR-107) in HSCC was significantly reduced. Subsequently, we screened out the downstream direct target gene Neuronal Vesicle Trafficking Associated 1 (NSG1) related to miR-107 through bioinformatics analysis and found that the expression of NSG1 was increased in HSCC tissues. Following the overexpression of miR-107 in HSCC cells, it was observed that miR-107 directly suppressed NSG1 expression, leading to increased apoptosis, decreased proliferation, and reduced invasion capabilities of HSCC cells. Subsequent experiments involving the overexpression and knockdown of NSG1 in HSCC cells demonstrated that elevated NSG1 levels enhanced cell proliferation, migration, and invasion, while the opposite effect was observed upon NSG1 knockdown. Further investigations revealed that changes in NSG1 levels in the HSCC cells were accompanied by alterations in ERK signaling pathway proteins, suggesting a potential regulatory role of NSG1 in HSCC cell proliferation, migration, and invasion through the ERK pathway. These findings highlight the significance of miR-107 and NSG1 in hypopharyngeal cancer metastasis, offering promising targets for therapeutic interventions and prognostic evaluations for HSCC.

Clinical Care Pathway Time Intervals and Tumor Progression Among Head and Neck Cancer Patients at East Avenue Medical Center Before and During the COVID-19 Pandemic

Objective: To investigate the association between the time intervals of key clinical time points and tumor progression (increase in clinical staging) in head and neck cancer patients before and during the pandemic. Methods: Design: Retrospective Cohort Study Setting: Tertiary Government Training Hospital Participants: A total of 81 head and neck cancer patients who consulted at the OPD and underwent elective surgery between January 1, 2018, and December 31, 2022, under the Department of Otorhinolaryngology – Head and Neck Surgery of East Avenue Medical Center were included in the study; 40 patients comprised the pre-pandemic group and 41 patients-the pandemic group. Results:Majority of patients were men (61.73%), and the mean age was 54 years. The most prevalent tumor site was the oral cavity (37.04%). Most patients were Clinical Stage IV at the time of diagnosis (32.10%) and at the time of surgery (58.02%). In the pre-pandemic period, median time-to-consult was 180 days, time-to-diagnosis was 14 days, and time-to-treatment was 57 days. During the pandemic, median time-to-consult significantly increased to 365 days (Mann-Whitney test, U = 589, p = .028), but time-to-diagnosis decreased to 10 days, and time to-treatment decreased to 43 days, although these were not significant (U = 775, p = .667; U = 809, p = .917). Among the 81 patients in the study, 14 (17.28%) showed tumor progression (pre-pandemic: 6; 15%; pandemic: 8; 19.51%), but there was no significant association between time-to-consult and increase in clinical staging for both pre-pandemic (χ2(38) = 34.2, p = .646) and pandemic groups (χ2(16) = 23.1, p = .110) or between time-to-diagnosis and increase in clinical staging for pre-pandemic (χ2(56) = 36.8, p = .978) and pandemic groups (χ2(23) = 28.3, p = .267). Overall, there was no significant association between time-to-treatment and increase in clinical staging for both pre-pandemic (χ2(62) = 80.00, p = .062) and pandemic groups (χ2(32) = 30.4, p = .548), but a subset of patients with larynx primary tumor site had a statistically significant association between time-to-treatment and tumor progression (χ2(5) = 12.00, p = .035). Conclusion:This study revealed that there was an increase in time to-consult for head and neck cancer patients during the pandemic. However, there was no significant difference in time-to-diagnosis and time-to-treatment. This shows that the Department of ORL-HNS, East Avenue Medical Center has provided pandemic head and neck cancer care similar to before the pandemic. No significant associations were found between tumor progression and time intervals of the key clinical time points but patients who had an increase in clinical stage were noted with longer time-to treatment. It was also observed that more patients were in advanced clinical stages during the pandemic.

Frequency of lymph node metastasis in differentiated thyroid carcinoma

Background: Although lymphatic metastasis does not affect overall survival for patients with differentiated thyroid carcinoma, locoregional control can be improved with cervical lymphadenectomy. The major morbidity of neck dissection (ND) for the management of regional metastasis is spinal accessory (CN XI) dysfunction. To avoid this complication, some surgeon advocates limited ND. This study aimed to analyze the frequency of lymph node metastasis in differentiated carcinoma of the thyroid. Methods: This cross-sectional observational study was conducted at the Department of Otolaryngology, Rajshahi Medical College Hospital, Rajshahi, and Department of Otolaryngology, Bangabandhu Sheikh Mujib Medical University (BSMMU), from July 2011 to Jun 2012. A total of 40 patients were selected as study subjects by simple random sampling technique. A descriptive analysis of data was carried out by using a statistical package for social science (SPSS) 22.0 for Windows. Results: In this study, a majority 35 (87.5%) of the patients suffered from papillary carcinoma, followed by 5 (12.5%) follicular carcinoma It was found that 18 (51.43%) patients had lymph node metastasis from papillary carcinoma of the thyroid. 10 (55.56%), and 4 (22.22%) patients had right and left-sided lymph node involvement respectively. Bilateral involvement was found in 4 (22.22%) patients. The predominant site of metastasis was level-III (77.3%) followed by level-VI (63.64%) nodal metastasis. Conclusions: This study concludes that metastasis in differentiated thyroid carcinoma is common. Lymph node metastasis is more common in papillary carcinoma than follicular carcinoma.

Epidemiological Profile of Hearing Deficiency in a Tertiary Care Hospital (2019-2022)

Abstract Introduction This study is an attempt to view the demographic profile of individuals presenting with hearing loss in an urban referral hospital with the help of available database of pure tone audiometry results over a three years period. Materials and methods It is adescriptive epidemiologicalstudy over a period of 3 years conducted in the Department of Otorhinolaryngology (ORL) of an urban referral hospital.The subjects presented with a complain of hearing loss were investigated with pure tone audiometry. Subjects below 10 years of age or with gross mental or physical disabilities were excluded. The results of pure tone audiometry done were analyzed followed by systematic analysis. Results A total number of 3536individuals inclusive of1980 males and1556 females were studied. Nearly, 570 individuals suffered B/L hearing loss (16%) which was again mostly Sensori-neural. Sensori-neural hearing loss was the most common hearing loss near about 52%.Mixed Hearing loss accounted for 13%.Conductive hearing loss accounted for 35 %. Mild hearing loss (25-40dB) accounted for maximum bulk of the patients.The bulk of the population comprised of people in their middle age (30-60) and elderly (&gt;60 years). Conclusion The demographic profile of hearing loss in an urban population is the ground work for any comprehensive planning to resolve the issue. In our study the increased burden of mild to moderate sensorineural hearing loss as seen in the elderly population and increased prevalence of conductive hearing loss as seen in the young population shows us how respective management protocols can be instituted for the target populations.

Thyroid cancer in patients undergoing thyroidectomy total in the Otorhinolaryngology Department of the Hospital de Clínicas during the period 2018-2022

Thyroid cancer in patients undergoing thyroidectomy total in the Otorhinolaryngology Department of the Hospital de Clínicas during the period 2018-2022

Evaluating the Impact of the COVID-19 Pandemic on Late-Canceled and No-Show Appointments at the Department of Neurological Surgery.

The coronavirus disease 2019 (COVID-19) pandemic resulted in unprecedented restrictions on the general public and disturbances to the routines of hospitals worldwide. These restrictions are now being relaxed as the number of vaccinated individuals increases and as the rates of incidence and prevalence decrease; however, they left a lasting impact on healthcare systems that is still being felt today. This retrospective study evaluated the total number of canceled or missed outpatient clinic appointments in a Neurological Surgery department before and after peak COVID-19 restrictions and attempted to assess the impact of these disruptions on neurosurgical clinical attendance. We also attempted to compare our data with the data from another surgical subspecialty department. We evaluated 32,558 scheduled appointments at the Loyola University Medical Center Department of Neurological Surgery, as well as 139,435 scheduled appointments with the Department of Otolaryngology. Appointments before April 2020 were defined as pre-COVID, while appointments during or after April 2020 were defined as post-COVID. Here, we compare no-show and non-attendance rates (no-shows plus late-canceled appointments) within the respective time range. Overall, we observed that before COVID-19 restrictions were put into place, there was an 8.9% no-show rate and a 17.4% non-attendance rate for the Department of Neurological Surgery. After COVID restrictions were implemented, these increased to 10.9% and 18.3%, respectively.Greater no-show and cancellation rates (9.8% in the post-COVID era vs 8.0% in the pre-COVID era) were associated with varying socioeconomic and racial demographics. African-American patients (2.56 times higher), new-visit patients (1.67 times higher), and those with Medicaid/Medicare insurance policies (1.48 times higher) were at the highest risk of no-show in the post-COVID era compared to the pre-COVID era.

Improving the complex therapy of dysphonia in respiratory infections and SARS-COV-2

Significantly aggravating the clinical course and negatively affecting the quality of life of patients, voice disorders in acute respiratory viral infection (ARVI) and SARS-CoV-2 require correction of treatment. Aim. To determine the effectiveness of Homeovox® in the complex therapy of dysfunctions in patients with respiratory infections and SARS-CoV-2 Materials and methods. The clinical study was conducted by a single-stage observational method, without intervention, at the clinical base of the Department of Otorhinolaryngology of the South Ural State Medical University in the period 2022–2023. The results of a study of 45 patients who suffered from acute respiratory and coronavirus infection SARS-CoV-2, accompanied by dysphonia, are presented. Results. There was a significant difference in the results of conservative treatment of patients previously divided into 2 groups according to the study design. Thus, in the second group (n=22), in addition to medical and economic standards, who received a multicomponent homeopathic medicine in accordance with the instructions, earlier recovery periods and statistically reliable restoration of vocal function were established until complete restoration of vocal function. Standard medical and economical therapy of patients of the first (n=23) and second groups included: administration of antiviral and antihistamines, local decongestants, irrigation therapy, symptomatic treatment. Conclusion. The assessment of dysphonia on three scales: the VASH scale, the Wilson Yanagihara scale and the GRBAS classification of voice disorders confirmed the restoration of voice function and recovery at an earlier date in patients who additionally took a homeopathic drug

Construction of an information model and predictors of the effectiveness of comprehensive medical rehabilitation of patients with polypous rhinosinusitis

Abstract. Analysis of predictors of the effectiveness of new methods of treating common somatic diseases is increasingly becoming an integral part of modern scientific medical research, since it solves several problems. Purpose: a comprehensive assessment of predictors of the effectiveness of medical rehabilitation of patients with polypous rhinosinusitis based on various mathematical approaches. Material and methods: The study was carried out on the basis of the Department of Otorhinolaryngology and Maxillofacial Surgery of the Federal State Budgetary Institution «Clinical Hospital No. 1» of the UDP of Russia with the participation of 30 patients with PRS; the average age of the patients was 42.9+0.51 years. All patients gave written informed consent to participate in the study. Comprehensive rehabilitation of patients included the endonasal use of Nasonex, subcutaneous administration of the drug dupilumab, an alternating magnetic field and low-intensity infrared laser radiation. Results: Statistical analysis of predictors of treatment efficacy in patients with polyposis rhinosinusitis who received dupilumab, low-intensity infrared laser into the nasal cavity and alternating magnetic field was performed. Matrix correlation analysis of 15 indicators characterizing the initial state of patients showed the presence of pronounced multicollinearity, which allowed us to reduce the number of independent variables to four. Regression analysis to assess the predictor significance of these indicators (results of SNOT-32 questionnaire, Lund — Mackay scale, blood content of eosinophilic cationic protein and interleukin 4) showed that Lund — Mackay scale values have an unreliable effect on the change of the dependent variable — parameters of the International Classification of Functioning, Disability and Health (ICF). It was revealed that the accuracy of the prediction is quite high and exceeds 90 %. Application of other variants (logit regression and piecewise regression) proved to be less effective It is proved that the effectiveness of treatment is maximized at the minimum values of the above mentioned independent variables.

Effect of mecobalamin combined with holographic copper acupuncture and scraping technique on tinnitus symptoms in patients with sudden sensorineural hearing loss

Purpose: To examine the effect of methylcobalamin combined with holistic copper acupuncture and scraping technique in ameliorating tinnitus symptoms in patients with sudden sensorineural hearing loss. Methods: 80 patients with sudden sensorineural hearing loss from Department of Otolaryngology, The Hefei First People’s Hospital, Hefei, China were selected as subjects for this study. They were divided into control and study groups, respectively, with 40 patients in each group, based on the different treatment interventions received by the patients. Conventional interventions included the use of Ginkgo biloba extract, Tianmasu injection, dexamethasone pharmacological treatments. The control group received methylphenidate tablets in addition to the conventional treatment, while the study group received further intervention comprising the combination of holistic copper acupuncture and scraping technique on the ear, in addition to the treatment received by the control group. The evaluated outcomes included efficacy, auditory threshold levels, and Pittsburgh Sleep Quality Index (PSQI) score. Results: The overall efficacy of the treatment in the control group was 77.5 %, whereas, it was significantly higher in the study group at 97.5 % (p &lt; 0.05). Prior to treatment, there were no significant differences in pure tone audiometry thresholds between the two groups (p &gt; 0.05). However, post-treatment, the study group exhibited significantly lower pure tone audiometry thresholds compared to the control group (p &lt; 0.05). Before PSQI scores were similar for the two groups (p &gt; 0.05). However, after treatment, the PSQI scores in the study group were significantly lower than those in the control group (p &lt; 0.05). Conclusion: The combined application of methylcobalamin, holistic copper acupuncture, and scraping technique is effective for the treatment of patients with sudden sensorineural hearing loss. This integrated treatment approach significantly alleviates tinnitus and improves sleep-related symptoms in patients with sudden sensorineural hearing loss. Furthermore, it promotes the recovery of pure tone audiometry thresholds and other related parameters.

Improving Environmental Sustainability of Operating Theatres: A Systematic Review of Staff Attitudes, Barriers, and Enablers.

To understand views of staff in relation to attitudes, enablers, and barriers to implementation of environmentally sustainable surgery in operating theatres. This will ultimately help in the goal of successfully implementing more sustainable theatres. Global healthcare sectors are responsible for 4.4% of greenhouse gas emissions. Surgical operating theatres are resource intensive areas and improvements will be important to meet Net-Zero carbon emissions within healthcare. Three databases were searched (Web of Science, Ovid and PubMed), last check January 2024. We included original manuscripts evaluating staff views regarding sustainable operating theatres. The Mixed Methods Appraisal Tool was used for quality appraisal and data analysed using thematic synthesis. 2933 articles were screened and 14 fulfilled inclusion criteria, using qualitative (1), quantitative (2), and mixed methods (11). Studies were undertaken in a variety of clinical (Department of Anaesthesia, Surgery, Otolaryngology, Obstetrics & Gynaecology and Ophthalmology) and geographical settings (Australia, Canada, France, Germany, New Zealand, USA, UK & Ireland,). Across studies there was a lack of evidence exploring enablers to implementation, but barriers mainly related to the following themes: education and awareness, leadership, resistance to change, facilities and equipment, time, and incentive. This systematic review identified attitudes and barriers perceived by clinicians towards improving environmental sustainability within operating theatres, which may inform future strategy towards sustainable surgery. Most studies used a survey-design, whereas use of interviews may provide deeper insights. Future work should be extended to wider stakeholders influencing operating theatres. Additionally, implementation studies should be carried out to examine whether barriers do change in practice. This systematic review identified attitudes and barriers perceived by clinicians towards improving environmental sustainability within operating theatres, which may inform future strategy towards sustainable surgery. Most studies used a survey-design, whereas use of interviews may provide deeper insights. Future work should be extended to wider stakeholders influencing operating theatres. Additionally, implementation studies should be carried out to examine whether barriers do change in practice.

Pleomorphic adenoma of the submandibular gland: a case report

Salivary gland tumors are relatively rare and constitute only about 1-4 % of head and neck tumors. Pleomorphic adenoma (PA) is the most common benign tumor of salivary glands. Approximately 80% of pleomorphic adenomas occur in the parotid gland, rest 10-20% in submandibular and minor salivary glands. Here, we present a confirmed case of pleomorphic adenoma of the submandibular gland. July 2024; Vol. 18(2):004. DOI: https://doi.org/10.55010/imcjms.18.016 *Correspondence: Zeeshan Ahmad, Department of Otorhinolaryngology, ESIC Medical College Hospital, Bihta , Patna - 801103, Bihar, India. Email: ahmad66zeeshan@gmail.com

Dentist Involvement in the Treatment of Radiation-Induced Oral Mucositis-A Pilot Cross-Sectional Study.

Objectives: Oral mucositis (OM) occurs in more than 95% of patients irradiated in the head and neck area. This paper aims to determine the occurrence and characteristics of OM in patients with head and neck cancer (HNC), as well as the involvement of dentists/oral medicine specialists in treating such patients. Methods: This study was conducted at the Department of Otorhinolaryngology and Department of Oral Medicine, University Hospital Center Zagreb, from April to August 2022, on patients irradiated in the head and neck area. A unique OM questionnaire was created on the incidence, characteristics, oral care, and involvement of dentists in the overall care. Results: Thirty patients filled out the questionnaire. Of the 22 patients who had developed OM, 14 had grade-three OM. Ten patients were treated for OM in line with the instructions of an oral medicine specialist, eight based on the instructions of a specialist responsible for monitoring of the underlying disease, and four were not treated at all. Sixteen patients had not been referred to a dentist before the start of RT. Conclusions: These results showed insufficient care and treatment of OM, as well as insufficient involvement of dentists in the oncology team.