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World Journal of otorhinolaryngology-head and neck surgery 2020年第S01期6卷 S2-S5页

作者： Kai Xu Xiaoquan Lai Zheng Liu department of otorhinolaryngology head and neck surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China department of Nosocomial Infection Management Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

The epidemic of the Coronavirus Disease 2019(COVID-19)has presented as a grim and complex situation recently.More than 77,000 cases of COVID-19 has been confirmed in China until February 25th,2020,which are causing great impact on economy and society,as well as seriously interfering with ordinary medical practice in the department of otorhinolar-yngology head and neck surgery.This article discussed medical precautions required in the clinic,inpatient ward and operation room of otorhinolaryngology head and neck department,which aims to protect health care workers from COVID-19.

关键词： Coronavirus disease 2019 SARS-CoV-2 Viral pneumonia Precautions Suggestion

Prevention of nosocomial COVID-19 infections in otorhinolaryngology-head and neck surgery

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World Journal of otorhinolaryngology-head and neck surgery 2020年第S01期6卷 S6-S10页

作者： Jie Ren Xilin Yang Zhen Xu Weiwei Lei Kun Yang Yonggang Kong Jining Qu Hua Liao Yi He Huidong Chen Yan Wang Feng Zeng Qingquan Hua Department of Otorhinolaryngology-Head and Neck Surgery Renmin Hospital of Wuhan UniversityWuhanHubei ProvinceChina

Coronavirus disease 2019(COVID-19)has rapidly evolved into a pandemic,causing a global public health crisis.Many frontline healthcare workers providing ear,nose and throat services have been reported to contract COVID-19 at work.Early during the COVID-19 outbreak,several medical professionals in Otolaryngology-head and neck surgery were in-fected in Wuhan,China.A series of measures were then taken immediately,which successfully halted the spread of the disease.Here we would like to share the lessons we have learned,and our experience to protect our health care workers during the COVID-19 pandemic.

关键词： COVID-19 Nosocomial infection Prevention

Postoperative surgical site infection in cholesteatoma surgery with and without mastoid obliteration, what can we learn?

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Journal of Otology 2022年第1期17卷 25-30页

作者： F.L.J.Cals H.F.E.van der Toom R.M.Metselaar A.van Linge M.P.van der Schroeff R.J.Pauw department of otorhinolaryngology and head and neck surgery Erasmus Medical CenterRotterdamthe Netherlands

Introduction:This study aims to describe the occurrence of postoperative complications related to cholesteatoma surgery and to determine factors influencing the most common complication,i.***.postoperative surgical site infection(SSI)in cases with and without mastoid obliteration.Materials and methods:Retrospective analyses were performed on surgically treated cholesteatomas in our hospital between 2013 and 2019.Patient characteristics,peri-and postoperative management and complications were reviewed.The cases were divided into two groups based on whether mastoid obliteration was performed or not.Results:A total of 336 cholesteatoma operations were performed,of which 248 cases received mastoid obliteration.In total 21 complications were observed,of which SSI was the most common(15/21).No difference in occurrence of any postoperative complication was seen between the obliteration and noobliteration group(p=0.798),especially not in the number of SSI(p=0.520).Perioperative and/or postoperative prophylactic antibiotics were not associated to the development of an SSI in both groups.In the no-obliteration group a younger age(p=0.015),as well as primary surgery(p=0.022)increased the risk for SSI.In the obliteration group the use of bioactive glass(BAG)S53P4 was identified as independent predictor of SSI(p=0.008,OR 5.940).Discussion:SSI is the most common postoperative complication in cholesteatoma surgery.The causes of SSI are multifactorial,therefore further prospective research is needed to answer which factors can prevent the development of an SSI in cholesteatoma surgery.

关键词： Cholesteatoma Mastoid obliteration Postoperative surgical site infection Complications Bioactive glass S53P4

Vestibular and cochlear dysfunction in aging:Two sides of the same coin?

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World Journal of otorhinolaryngology-head and neck surgery 2022年第4期8卷 308-314页

作者： Catia Azevedo Sergio Vilarinho Ana Sousa Menezes Fernando Milhazes Mar Luis Dias Department of Otorhinolaryngology-Head and Neck Surgery Hospital de BragaBragaPortugal

Objective:Nonspecific complaints of hearing loss,vertigo,imbalance,and instability,without a defined etiology,are very prevalent in the elderly population,with a great impact on morbidity and mortality in this age group.The objectives of this study were to verify whether there is age-related vestibular dysfunction and to test the association of vestibular dysfunction with presbycusis in the elderly population.Methods:Original retrospective analytical cross-sectional study,carried out with 80 patients who underwent a videonystagmography and complete audiometric evaluation due to nonspecific vestibular complaints,without a specific vestibular disorder diagnosis.Patients were selected and divided into two distinct age groups(group A:>60 years;group B:18-50 years)and,in both groups,we analyzed the caloric tests and the pure-tone audiometry.Results:In the vestibular evaluation,we found that there was a statistically significant difference(P<0.05)between groups in the prevalence of bilateral vestibular weakness(group A:22.5%;group B:5%),and that the increase in age,above 60 years,is negatively correlated with the mean total caloric response.Additionally,we obtained a reasonable negative and statistically significant correlation(r=-0.320,P<0.05)between the mean bone conduction thresholds at high frequencies and total caloric responses in group A.Conclusions:In patients with hearing loss,it is essential to perform a complete vestibular study to diagnose vestibular disorders and,consequently,prevent adverse outcomes that may result from these alterations.

关键词： aged bilateral vestibulopathy caloric tests presbycusis vertigo

Frequency of otitis media with effusion among children aged 1-5 years presenting to immunization center of tertiary care hospitals,Rawalpindi

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World Journal of otorhinolaryngology-head and neck surgery 2022年第4期8卷 315-320页

作者： Nida Riaz Muhammad Ajmal Muhammad Sheharyar Khan department of otorhinolaryngology and head and neck surgery Holy Family HospitalRawalpindiPakistan department of otorhinolaryngology and head and neck surgery HBS Medical CollegeIslamabadPakistan Rawalpindi Medical University RawalpindiPakistan

Objective:We conducted this study to assess the etiopathogenic relation of otitis media with effusion(OME)in a group of children aged 1-5 years among the local population of Rawalpindi.Methods:This was a cross-sectional retrospective study.Study was conducted among the children presenting to the immunization center of three tertiary care hospitals of Rawalpindi.Otitis media was assessed by clinical examination and tympanometry from August 2019 to January 2020.Multi-factor regression analysis was then applied to recognize the statistical significance and association of various risk factors to OME.Results:Out of 400 children enrolled in this study,108(27.0%)had OME,out of which 65(60.2%)were males and 30(27.8%)were of age group 2-3 years.Multivariable regression analysis of risk factors associated with OME showed it was strongly associated with snoring(P<0.001),last year symptoms(attack of ear aches with hearing loss[P=0.002]),drugs(URTI antibiotics[P=0.026],All 3 drugs[P=0.013]).Conclusions:We found out that OME is a common disease which if not identified or treated timely can lead to other hard to cure health problems.Control of its etiopathogenic factors can play a major role in its prevention.

关键词： Etiology Low resource country Otitis media with effusion Prevelance Tympanometry

Evaluation of pure-tone audiometric protocols in vestibular schwannoma screening

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Journal of Otology 2021年第3期16卷 138-143页

作者： Matej Vnencak Elina Huttunen Antti A.Aarnisalo Jussi Jero Katja Liukkonen Saku T.Sinkkonen Department of Otorhinolaryngology-Head and Neck Surgery Turku University HospitalTurkuFinland head and neck Center Otorhinolaryngology-Head and Neck SurgeryHelsinki University HospitalAnd University of HelsinkiHelsinkiFinland

The objective was to evaluate the pure-tone audiogram-based screening protocols in VS diagnostics.We retrospectively analyzed presenting symptoms,pure tone audiometry and MRI finding from 246 VS patients and 442 controls were collected to test screening protocols(AAO-HNS,AMCLASS-A/B,Charing Cross,Cueva,DOH,Nashville,Oxford,Rule3000,Schlauch,Seattle,Sunderland)for sensitivity and specificity.Results were pooled with data from five other studies,and analysis of sensitivity,specificity and positive likelihood ratio(LR+)for each protocol was performed.Our results show that protocols with significantly higher sensitivity(AMCLASS-A/B,Nashville)show also significantly lowest specificity,and tend to have low association(positive likelihood ratio,LR+)to the VS.The highest LR+was found for protocols AAO-HNS,Rule3000 and Seattle.In conclusions,knowing their properties,screening protocols are simple decision-making tools in VS diagnostic.To use the advantage of the highest sensitivity,protocols AMCLASS-A+B or Nashville can be of choice.For more reasonable approach,applying the protocols with high LR+(AAO-HNS,Rule3000,Seattle)may reduce the overall number of MRI scans at expense of only few primarily undiagnosed VS.

关键词： Vestibular schwannoma Asymmetric sensorineural hearing loss Screening protocol

The diagnosis of central vestibular disorders based on the complementary examination of the vestibulospinal reflex

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Journal of Otology 2022年第1期17卷 1-4页

作者： Stefani Maihoub Andras Molnar Laszl Tamas Agnes Szirmai department of otorhinolaryngology and head and neck surgery Faculty of MedicineSemmelweis UniversityBudapestHungary

Objectives:Stance and gait unsteadiness along with vertigo contribute to a central vestibular disorder.For objective analysis ultrasound-computer-craniocorpography(US-COMP-CCG)can be used.Aim of the study was to characterize the unsteadiness in central vestibular disorders and discuss the possible diagnostic usage of US-COMP-CCG.Methods and results:Hundred-and-ninety patients(70 male and 120 female,mean age±SD,58.94±15.27)suffering from central vestibular disorder and 230 healthy control patients(78 male and 152 female,mean age±SD,50.94±15.27)were enrolled.Stance and gait analysis was according to vestibulospinal tests of US-COMPCCG.IBM SPSS V24 software was used for statistical analysis.Mann-Whitney U test and Chi-square test were used,along with sensitivity and specificity categorization.The significance level was phead covering area parameters(p=0.0001);stepping test:longitudinal deviation(p=0.05),lateral sway(p=0.011)parameters].Conclusions:Clinicians should consider that postural instability is prominently present in this population and might be of a diagnostic importance.

关键词： Unsteadiness Central vestibular disorder Vestibulospinal reflex Ultrasound-computer-craniocorpography

Microdebrider complications in sinus surgery:Analysis of the openFDA database

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World Journal of otorhinolaryngology-head and neck surgery 2023年第4期9卷 328-332页

作者： Elias S.Saba Jacob Hoerter Jeremy Chang David W.Chou Chris Xiao Jacob G.Eide Rijul S.Kshirsagar James N.Palmer Nithin D.Adappa department of head and neck surgery Kaiser Permanente Oakland Medical CenterOaklandCaliforniaUSA department of otorhinolaryngology‐headand neck surgery Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA department of Otolaryngology‐head and neck surgery Mount Sinai Medical CenterNew YorkNew YorkUSA department of otorhinolaryngology‐head and neck surgery University of PennsylvaniaPhiladelphiaPennsylvaniaUSA

Objective:Functional endoscopic sinus surgery is a commonly performed otolaryngologic procedure that often uses the microdebrider device for tissue removal.Given the ubiquitous nature of the instrument,we sought to better define the patterns of device failure using the postmarket surveillance openFDA database.Methods:The openFDA database was queried for all microdebrider‐related adverse events from January 1,2000 to November 1,2020.Descriptive information on the nature of device failure and any associated patient injury was compiled.Reports not directly related to device failure were excluded from the analysis.Results:A total of 641 events were included in the analysis.The most common device failure was overheating(n=348,54.3%),followed by material separation(n=173,27%),and inconsistent device activation(n=52,8.1%).Of the reported events,the vast majority did not result in patient harm(n=579,90.3%).On review of the remaining cases,only 24 events(3.7%)resulted in true harm to the patient,defined as a temporary or permanent injury or>30 min of additional anesthesia time.Of these cases,the need to reschedule surgical cases(n=5,0.8%),retained foreign body(n=5,0.8%),and thermal tissue injury(n=3,0.5%)were the most common.Five patients suffered an injury due to surgeon error unrelated to device malfunction(n=5,0.8%).Conclusions:Microdebrider device failures are extremely rare.When they do occur,less than 10%result in patient harm.In cases of patient harm related to microdebrider failure,preoperative testing of the device before use could prevent many of the reported malfunctions.

关键词： device failure microdebrider openFDA outcomes sinus

Otitis media with effusion in children: Pathophysiology, diagnosis, and treatment.A review

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Journal of Otology 2019年第2期14卷 33-39页

作者： Pauline Vanneste Cyril Page department of otorhinolaryngology and head & neck surgery Amiens University Hospital

Otitis media with effusion(OME)is a frequent paediatric disorder.The condition is often asymptomatic,and so can easily be missed.However,OME can lead to hearing loss that impairs the child's language and behavioural development.The diagnosis is essentially clinical,and is based on otoscopy and(in some cases)tympanometry.Nasal endoscopy is only indicated in cases of unilateral OME or when obstructive adenoid hypertrophy is suspected.Otitis media with effusion is defined as the observation of middle-ear effusion at consultations three months apart.Hearing must be evaluated(using an age-appropriate audiometry technique)before and after treatment,so as not to miss another underlying cause of deafness(e.***.perception deafness).Craniofacial dysmorphism,respiratory allergy and gastro-oesophageal reflux all favour the development of OME.Although a certain number of medications(antibiotics,corticoids,antihistamines,mucokinetic agents,and nasal decongestants)can be used to treat OME,they are not reliably effective and rarely provide long-term relief.The benchmark treatment for OME is placement of tympanostomy tubes(TTs)and(in some cases)adjunct adenoidectomy.The TTs rapidly normalize hearing and effectively prevent the development of cholesteatoma in the middle ear.In contrast,TTs do not prevent progression towards tympanic atrophy or a retraction pocket.Adenoidectomy enhances the effectiveness of TTs.In children with adenoid hypertrophy,adenoidectomy is indicated before the age of 4 but can be performed later when OME is identified by nasal endoscopy.Children must be followed up until OME has disappeared completely,so that any complications are not missed.

关键词： Otitis media with effusion Tympanostomy tube Ventilation tube Grommet Child

Lentivirus-Mediated Short Hairpin RNA for Follistatin Downregulation Suppresses Tumor Progression in Hypopharyngeal Carcinoma

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Current Medical Science 2022年第4期42卷 832-840页

作者： Liang GE Shao-feng LIU department of otorhinolaryngology head and neck surgery the Yijishan Hospital of Wannan Medical CollegeWuhu 241001China

Objective:Follistatin(FST)inhibits the action of activin by interfering with the binding of activin to its receptor.Although the prognostic value of FST in various cancers has been investigated previously,studies rarely focused on hypopharyngeal carcinoma(HPC).In our study,the effect of FST expression on HPC tissues and cell lines was investigated.Methods:A total of 60 patients with HPC were recruited for this study.Levels of FST mRNA and protein were measured by quantitative polymerase chain reaction(PCR)and immunohistochemistry in HPC tissue samples and by qPCR in the HPC FaDu cells,as well as immortal nasopharyngeal epithelial cell line NP-69 cells.After silencing the FST expression in FaDu cells using lentivirus-mediated siRNA that was specific for FST mRNA,cell proliferation was determined by a Celigo assay.Tumor growth was monitored in nude mice and viability was determined by a methylthiazoletetrazolium assay.The ratio of cell cycle arrest and apoptosis was evaluated by flow cytometry.The colony formation ability was performed using Giemsa staining.In addition,wound healing and Transwell migration and invasion assays were performed for the analysis of cell motility.Results:FST expression was significantly higher in human HPC tissue and FaDu cells than in normal tissue and NP-69 cells.A higher expression of FST in HPC samples was positively correlated with advanced tumors.Moreover,FST knockdown by shRNA significantly decreased cell growth,colony formation,migration and invasion.Furthermore,FST silencing increased the cell apoptosis percentage,and arrested cell cycle in the S phase in FaDu cells.In addition,FST silencing suppressed tumor growth in vivo.Conclusions:Our results indicated that the FST gene was associated with HPC progression and may serve as a potential therapeutic target for the treatment of HPC.

关键词： follistatin hypopharyngeal carcinoma migration invasion proliferation apoptosis