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The use of Montgomery salivary bypass tubes and pharyngocutaneous fistula following salvage laryngectomy

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World Journal of Otorhinolaryngology-head and neck Surgery 2024年第1期10卷 43-48页

作者： Courtney B.Shires Mackenzie Latour Merry Sebelik Karuna Dewan West Cancer Center GermantownTennesseeUSA department of otolaryngology-head and neck Surgery Louisiana State University Health ShreveportShreveportLouisianaUSA department of otolaryngology-head and neck Surgery Emory UniversityAtlantaGeorgiaUSA

Objectives:Pharyngocutaneous fistula(PCF)is the most common complication to follow total laryngectomy(TL)and is associated with increases in length of hospital stay and with a need for revision surgery or readmission,as well as with delays in return to oral diet.Patients who require salvageTL(STL)or primary(chemo)radiation therapy are at higher risk for developing PCF.Due to the quality‐of‐life burden of PCF on patients,limiting this occurrence is crucial.Methods:We conducted a retrospective cohort study of patients undergoing STL with placement of Montgomery salivary bypass tube(MSBT)^(TM)for at least 2 weeks duration between 2013 and 2017 at a single institution.Our patients all underwent free flap reconstruction.Our primary outcome of interest was development of PCF.Secondary outcomes included demographics,previous treatment,base of tongue(BOT)involvement,extent of defect,concurrent neck dissection(ND),and margin status.Univariateχ^(2) analysis was used to evaluate factors associated with PCF.Results:Forty‐four patients underwent STL with Montgomery tube placement and free flap reconstruction.Eight developed PCF(18.2%).The average age was 61.6 years;36 patients were male(81.8%),whereas eight patients were female(18.2%).There was no association between PCF and previous chemoradiation versus radiation(15.8%vs.33.3%,P<0.30),BOT involvement versus not(11.1 vs.22.2%,P<0.38),circumferential versus partial defect(18.8%vs.17.9%,P<0.94),ND versus none(10%vs.25%,P<0.20),or margin status.Conclusion:PCF complicated 18.2%of STL cases at our institution and was not associated with differences in primary treatment modality,presence of concomitant ND,extent of pharyngeal defect,BOT involvement,or positive frozen or permanent surgical margin.

关键词： free flap reconstruction Montgomery pharyngocutaneous fistula salivary bypass tube salvage total laryngectomy total laryngectomy

The application of the strip-shaped cymba conchae orthosis in the nonsurgical correction of complex auricular deformity

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Journal of Otology 2024年第1期19卷 24-29页

作者： Huijuan Xu Shaoguang Ding Fei Zhang Zhifeng Zhang Xiangyu Chen Mingyang Li Haitao Yang Fugen Han Hongjian Liu department of otolaryngology head and neck Surgery People’s Hospital of Henan UniversityHenan Provincial People’s HospitalZhengzhouChina department of otolaryngology head and neck Surgery Henan Provincial People’s HospitalPeople’s Hospital of Zhengzhou UniversityPeople’s Hospital of Henan UniversityZhengzhouChina department of otolaryngology head and neck Surgery Henan Children’s HospitalZhengzhouChina department of otolaryngology head and neck Surgery The Third People’s Hospital of ZhengzhouZhengzhouChina Zheng Dong Mihuan Clinic ZhengzhouChina

Objective: This study aims to evaluate the efficacy and safety of using a strip-shaped cymba conchae orthosis for the nonsurgical correction of complex auricular deformities. Methods: Clinical data were collected from 2020 to 2021 for 6 patients who underwent correction using a stripshaped cymba conchae orthosis. The indications, corrective effects, and complications associated with use of the orthosis were analyzed. Results: There were four indications for treatment: cryptotia with helix adhesion;cryptotia with grade I microtia;cryptotia with excessive helix thickness;and auricular deformity beyond the treatment time window(≥6 months). Excellent corrective effects were observed in all 6 patients. Complications occurred in one patient, who recovered after symptomatic treatment. Conclusion: The use of a strip-shaped cymba conchae orthosis alone or combined with a U-shaped helix orthosis presents a feasible approach for correcting complex auricular deformities or deformities beyond the treatment time window in pediatric patients.

关键词： Cymba conchae Auricular deformity Cryptotia Nonsurgical correction Orthosis

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World Journal of Otorhinolaryngology-head and neck Surgery 2024年第2期10卷 97-104页

作者： Mihai A.Bentan Evan R.Reiter Richard M.Costanzo Daniel H.Coelho department of otolaryngology-head&neck Surgery Virginia Commonwealth University School of MedicineRichmondVirginiaUSA

Objective:The aim of this study was to review findings from a large prospective national database of chemosensory disturbances associated with coronavirus disease 2019(COVID-19)infection.Data Sources:The Virginia Commonwealth University Smell and Taste Center national database of COVID-19 chemosensory disturbances.Methods:A series of online surveys,first opened on April 10,2020,was made accessible nationwide to any adult with sudden chemosensory dysfunction since January 2020.Participants received subsequent follow-up surveys 14 days,1 month,3 months,and 6 months after enrollment.An additional survey was sent to all participants on May 28,2022 to assess long-term outcomes.Information pertaining to demographics,symptoms,comorbidities,treatments,and life impact was collected.Results:Of 363 participants who reported complete smell recovery,51.2%recovered within 1 month,70%within 3 months,and 79%within 6 months,while 8.8%took over 1 year to completely recover.Among all participants,7.5%had no smell recovery.Positive predictors of recovery included agehead injury.Many participants reported a decrease in quality of life and the presence of potential safety hazards associated with decreased smell loss.Conclusions:Most subjects with COVID-19-related chemosensory dysfunction recover,with the majority noting complete recovery within weeks of infection.Those aged over 40 years and female gender were associated with lower rates of recovery.A considerable number of participants reported significant impact on quality of life and safety.

关键词： anosmia COVID-19 smell

Comparison of trigeminal lateralization with differing stimulants

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World Journal of Otorhinolaryngology-head and neck Surgery 2024年第1期10卷 66-69页

作者： Tiffany Chen Nicolas S.Poupore Michael C.Shih Thomas S.Edwards Shaun A.Nguyen Zachary M.Soler Rodney J.Schlosser department of otolaryngology‐head and neck Surgery Medical University of South CarolinaCharlestonSouth CarolinaUSA

Trigeminal-specific stimulants have been shown to activate different receptors preferentially and this likely accounts for variation in sensory perception.It is unclear whether trigeminal sensitivity is similar across different transient receptor potential(TRP)receptors or if dysfunction of different receptors results in differing patient symptoms.Therefore,a prospective cohort study was conducted,consisting of trigeminal lateralization testing with three different stimulants(eucalyptol,isothiocyanate,acetic acid),olfaction testing with Sniffin'Sticks,and measurement of various patient‐reported outcome measures(PROMs).A total of 50 participants were enrolled across the olfactory spectrum.Mean TDI score was 27.1±8.3(range 7.0–39.5)with 38%normosmic and 62%dysosmic.Mean trigeminal lateralization scores out of 20 in the overall cohort were 16.18(2.78)for eucalyptol,14.94(3.49)for mustard oil,and 15.28(3.68)for vinegar.Eucalyptol showed a significant correlation with threshold scores of Sniffin'Sticks.A significant correlation was found between acetic acid and various PROMs.None of the lateralization scores of the trigeminal stimulants correlated to each other significantly and there was no correlation to age.The lack of correlation suggests that the measured sensitivity of one type of TRP receptor may not translate to similar sensitivity of the other receptors.Additional investigations with TRPV1 and TRPA1 agonists are needed to corroborate our findings.

关键词： chemosensory olfaction trigeminal TRP receptor

Translocation of a fish spike from the pharynx to the thyroid gland:A case report

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World Journal of Clinical Cases 2024年第7期12卷 1365-1370页

作者： Deng Li Wan-Ting Zeng Jian-Guo Jiang Ji-Chuan Chen department of otolaryngology head and neck Surgery Army Medical Center of PLAChongqing 400042China

BACKGROUND A fish spike stuck in the throat is a common ear,nose,and throat(ENT)emergency.However,it is very rare for a fish spike to reach the thyroid tissue through the throat,which is very dangerous and can lead to pharyngeal fistula,cervical abscess,mediastinal abscess,and thyroid abscess.Proper and timely management can help reduce complications,especially in elderly patients.CASE SUMMARY In the case presented here,the causative factor was dentures,but improper management aggravated the condition.In the case presented here,an elderly woman with a history of accidentally swallowing fish bones for 20 d had a sensation of foreign bodies in her throat.Eventually,computed tomography(CT)of the neck showed that the left side of the thyroid gland had a dense shadow in the form of a stripe.CONCLUSION If a fishbone foreign body is not visible during endoscopic examination but the patient has significant symptoms,the surgeon should be aware that the fishbone may be lodged in the thyroid.To avoid a misdiagnosis,ultrasound,CT,and other tests can be used to clarify the diagnosis.T The first step in treating a fish bone in the thyroid gland is to determine the position of the foreign body and the extent of the infection,and to develop a personalized surgical plan for its removal.At the same time,scientific information should be made available to the general public so that people know that if a fish bone is accidentally lodged,they should not force it to be swallowed or be spit out by inducing vomiting,which are incorrect methods and may aggravate the condition or even cause it to migrate outside the cavity,leading to serious complications,as in this reported case.

关键词： Fish spike Thyroid Pharynx Foreign body migration Case report

Utilization of RNA sequencing to investigate olfactory dysfunction in chronic rhinosinusitis without nasal polyps:A pilot study

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World Journal of Otorhinolaryngology-head and neck Surgery 2024年第1期10卷 29-36页

作者： Jorge A.Gutierrez III Jeremy L.Barth Rodney J.Schlosser Thomas S.Edwards Timothy L.Smith Zachary M.Soler department of otolaryngology-head and neck Surgery Medical University of South CarolinaCharlestonSouth CarolinaUSA department of Regenerative Medicine&Cell Biology Medical University of South CarolinaCharlestonSouth CarolinaUSA department of otolaryngology-head and neck Surgery Oregon Health&Science UniversityPortlandOregonUSA

Objectives:Prior research on olfactory dysfunction in chronic rhinosinusitis(CRS)has focused on patients with polyps and suggests that direct inflammation of the olfactory cleft mucosa plays a contributory role.The purpose of this study was to evaluate gene expression in superior turbinate mucosal specimens,comparing normosmic and dysosmic CRS patients without polyps(CRSsNP).Methods:Tissue samples were obtained from the superior turbinates of patients with CRSsNP at the time of endoscopic sinus surgery.Samples subsequently underwent RNA sequencing and functional analysis to investigate biological pathways associated with differentially expressed genes between dysosmic(n=7)and normosmic(n=4)patients.Results:Differential gene expression analysis comparing dysosmic and normosmic CRSsNP patients showed upregulation of 563 genes and downregulation of 327 genes.Using stringent criteria for multiple comparisons,one upregulated gene(Immediate Early Response 3[IER3])had an false discovery rate(FDR)correction adjustedP value considered statistically significant(P<0.001,fold change 2.69).Reactome functional analysis revealed eight biological pathways significantly different between dysosmic and normosmic patients(P<0.05,FDR correction)including IL-4 and IL-13 signaling,IL-10 signaling,and rhodopsin-like receptors.Conclusions:RNA sequencing of the superior turbinates in patients with CRSsNP can provide valuable information regarding biological pathways and genes involved in olfactory dysfunction.This study supports literature suggesting that Type 2 inflammation may play a role in olfactory dysfunction in at least some patients with CRSsNP.This study also prompts questions regarding the role of IL-10,rhodopsin-like receptors,andIER3 in the pathogenesis of olfactory dysfunction.

关键词： chronic rhinosinusitis without nasal polyps olfactory dysfunction RNA sequencing

Construction of a novel six-gene signature to predict tumour response to induction chemotherapy and overall survival in locoregionally advanced laryngeal and hypopharyngeal carcinoma

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Genes & Diseases 2024年第3期11卷 148-150页

作者： Chen Tan Lingwa Wang Yifan Yang Shizhi He George G.Chen Jason YK.Chan Michael CF.Tong C.A.van Hasselt Wenbin Xu Ling Feng Ru Wang Jugao Fang department of otolaryngology head and neck Surgery Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China Key Laboratory of otolaryngology head and neck Surgery(Ministry of Education of China) Beijing Institute of OtolaryngologyBeijing 100730China department of Otorhinolaryngology Head and Neck SurgeryThe Chinese University of Hong KongPrince of Wales HospitalHongKong SAR999077China department of Medical Genetics Institute of Basic Medical ScienceChinese Academy of Medical Science&Peking Union Medical CollageBeijing 100730China

Locoregionally advanced laryngeal and hypopharyngeal cancers(LA-LHCs)are traditionally treated with surgery followed by postoperative radiotherapy,which impairs speech and swallowing functions and reduces the quality of life.^(1,2)The use of induction chemotherapy(IC)as a larynxpreserving approach for LA-LHCs has been verified and refined.^(3)However,the short-term tumor response to IC varies,non-responders usually show poor survival and little benefit.

关键词： chemotherapy laryngeal surgery

Modified intratympanic steroid therapy for sudden sensorineural hearing loss via tympanic tube and gelfoam as a salvage treatment

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Journal of Otology 2024年第1期19卷 19-23页

作者： Sichao Liang Yunshuo Li Zhenping Guo Manlin Lu Xin Li Jia Xu Wenjing Chen Juanjuan Gao Haijin Yi department of otolaryngology Head and Neck SurgeryBeijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing102218China

Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.

关键词： Modified intratympanic steroid therapy Sudden sensorineural hearing loss Gelfoam Tympanic tube

Clinical studies in COVID-related olfactory disorders:Review of an institutional experience

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World Journal of Otorhinolaryngology-head and neck Surgery 2024年第2期10卷 129-136页

作者： Theresa Tharakan Dorina Kallogjeri Jay F.Piccirillo department of otolaryngology-head and neck Surgery Clinical Outcomes Research OfficeSchool of MedicineWashington University in St LouisSt LouisMissouriUSA

Objective:To share a single institutional experience with clinical research on COVID-related olfactory dysfunction(OD).Data Source/Method:Narrative review of published original data and ongoing clinical trials on COVID-related OD at Washington University from 2020 to 2023.Results:There were three new diagnostic-/patient-reported outcome measures developed and tested.We report five clinical trials of interventions for COVID-related olfactory disorders:combined Visual-Olfactory Training(VOLT)with patient-preferred scents versus standard olfactory training(VOLT trial),oral gabapentin versus placebo(Gabapentin for the Relief of Acquired Chemosensory Experience trial),nasal theophylline irrigations versus placebo(Smell Changes and Efficacy of Nasal Theophylline trial),stellate ganglion block(single-arm),and mindfulness-based stress reduction(MBSR)versus lifestyle intervention(MBSR trial).Conclusions:Initial intervention trials for COVID-related OD have shown potential for improving subjective and objective olfactory outcomes.However,there remains no gold standard treatment that definitively outperforms placebo in controlled trials.Therefore,continued investigation of novel therapeutic strategies for COVID-related OD is necessary to maximize olfactory outcomes for affected patients.

关键词： chemosensory disorders COVID olfactory dysfunction