Z Chen,Q Bi,Y Lv,Y Liu,Y Tian,J Liu,W Yang,Y Zhou,W Huang,Y Li
Publicatie 03-01-2025
Abstract Objectives This study examined the relationships between electrophysiological measures of the electrically evoked auditory brainstem response (EABR) with speech perception measured in quiet after cochlear implantation (CI) to identify the ability of EABR to predict postoperative CI outcomes. Methods Thirty-four patients with congenital prelingual hearing loss, implanted with the same manufacturer’s CI, were recruited. In each participant, the EABR was evoked at apical, middle, and basal electrode locations. The following EABR measures were analyzed: wave III and V input/output (I/O) function, latency, threshold, threshold0.5 μV and Gibson scoring. Patients’ speech perception abilities were assessed using the Mandarin Speech Perception (MSP) materials presented in quiet. The Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) were also used to assess CI outcomes. A regression model was developed to explore the relationship between EABR and each speech measure, to identify parameters with significant predictive ability. Results A significantly shorter eV latency, lower eV threshold, lower eV threshold0.5 μV and steeper I/O slopes for both eV and eIII were observed when these responses were evoked at the apical electrode, compared to the middle and basal positions. Implantation age was significantly negatively correlated with bisyllables recognition rate (R2 = 0.20, p = 0.0194). The eIII slope at the apical site and the eV slope at the basal site demonstrated the highest R2 values in positive correlation with CAP, both with R2 = 0.09. Among the EABR parameters, the regression models based on MSP bisyllables recognition rate, basal eV latency, eV thresholds and threshold0.5 μV recorded at the apical and middle positions were statistically significant. Conclusions Our study identified an apex-to-base gradient in EABR responsiveness following prolonged CI use. The threshold and I/O slopes of EABR appear to be informative predictors of speech perception performance in CI users, especially in the low-to-middle frequency range. However, further validation is needed.
Pubmed PDF WebPublicatie 03-01-2025
Abstract Purpose Cochlear implantation (CI) surgery is essential for restoring hearing in individuals with severe sensorineural hearing loss. Accurate placement of the electrode within the cochlea is essential for successful auditory outcomes and minimizing complications. This study aims to analyze the relationship between the round window niche (RWN) alignment, its visibility during surgery, and the impact on surgical techniques and outcomes. Methods A retrospective study was conducted, examining high-resolution computed tomography (CT) scans of the temporal bone from 103 patients who underwent CI. RWN visibility was assessed using the St. Thomas Hospital (STH) classification. Anatomical parameters such as the angles of RWN alignment relative to the lateral semicircular canal (LSCC) plane and the distances to the facial nerve were measured and recorded. Results The analysis revealed that RWN alignment angles did not significantly correlate with RWN visibility. However, specific anatomical distances, such as the anteroposterior distance between the round window membrane (RWM) and the facial nerve, were significantly associated with improved RWN visibility. Conclusion Preoperative knowledge of RWN anatomy, particularly its relationship with the facial nerve, can reduce the complexity of CI surgery. Understanding these anatomical variations is essential for optimizing surgical outcomes. Future research should explore additional cochlear axis orientations to enhance surgical techniques and improve visibility assessments during CI procedures.
Pubmed PDF WebEAC Dronkers,C Al Yaghchi,JR Lechien,C Sittel,A Geneid
Publicatie 02-01-2025
Abstract Introduction There are inconsistencies in how different endoscopic procedures to manage Bilateral Vocal Fold Immobility (BVFI) have been described in the literature. This limits our ability to compare functional outcomes. There is no unifying international terminology available that precisely describes the anatomical boundaries and extent of the different types of treatment. A pan-European consensus regarding terminology of different endoscopic surgical procedures to manage BVFI in adults was developed. Methods Thirty-one expert laryngologists and phoniatricians of the European Laryngological Society (ELS) or Union of the European Phoniatricians (UEP), participated in a modified Delphi process. They voted on an initial series of 13 proposed statements, including graphical visualization of different endoscopic surgical techniques for BVFI. Statements reaching > 70% of agreement in the first voting round were accepted. In the second voting round, eight revised and newly proposed statements were accepted with an increased threshold of > 80%. Results Fourteen statements were anonymously validated through two voting rounds. The following categories of endoscopic arytenoid and vocal fold surgery were defined: total arytenoidectomy, partial arytenoidectomy (subclassified into subtotal, anteromedial, posteromedial and superomedial), posterior cordectomy (subclassified into ligamental, transmuscular and ventriculocordectomy) and transverse cordotomy (subclassified into posterior cordotomy and ventriculocordotomy). The suffixes ‘with mucosal preservation’, ‘with laterofixation’ and ‘combined procedure’ were defined too. Conclusion This ELS-UEP consensus on endoscopic arytenoid and vocal fold surgery for BVFI provides a practical nomenclature and classification to improve reporting in literature and clinical practice and to allow comparison of functional outcomes.
Pubmed PDF WebRD Traglia,H Dunne,J Tysome,ME Smith
Publicatie 30-12-2024
VM Asensio-Sánchez
Publicatie 30-12-2024
P Arnold,L Fries,RL Beck,S Granitzer,M Reich,A Aschendorff,S Arndt,MC Ketterer
Publicatie 30-12-2024
Abstract Objectives In times of an aging society and considering the escalating health economic costs, the indications for imaging, particularly magnetic resonance imaging (MRI), must be carefully considered and strictly adhered to. This cadaver study aims to examine the influence of cochlear implant (CI) on the assessment of intracranial structures, artifact formation, and size in cranial MRI (cMRI). Furthermore, it seeks to evaluate the potential limitations in the interpretability and diagnostic value of cMRI in CI patients. Additionally, the study investigates the imaging of the brain stem and the internal ear canal and the feasibility of excluding cholesteatomas in cMRI for CI patients. Materials and methods Two cadaveric specimens were implanted with cochlear implants at varying angular positions (90°, 120°, and 135°), both unilaterally and bilaterally, with and without magnet in situ. MRI acquisition consisted of sequences commonly used in brain MRI scans (T1-MP-RAGE, T2-TSE, T1-TIRM, DWI, CISS). Subsequently, the obtained MRI images were manually juxtaposed with a reference brain from the Computational Anatomy Toolbox CAT12. The size and formation of artifacts were scrutinized to ascertain the assessability of 22 predefined intracranial structures. Furthermore, the internal auditory canal, middle ear and mastoid were evaluated. Results The cadaveric head mapping facilitated the analysis of all 22 predefined intracranial structures. Artifacts were assessed in terms of their minimum and maximum impact on image comparability. Image quality and assessability were stratified into four categories (0–25%, 25–50%, 50–75%, and 75–100% of assessability restriction). The visualization of the central, temporal, parietal, and frontal lobes was contingent upon CI positioning and the choice of imaging sequence. Diffusion-weighted cMRI proved inadequate for monitoring cholesteatoma recurrence in ipsilateral CI patients, regardless of magnet presence. The ipsilateral internal auditory canal was inadequately visualized in both magnet-present and magnet-absent conditions. We divided our results into four categories. Category 3 (orange) indicates considerable limitations, while category 4 (red) indicates no interpretability, as the image is entirely obscured by artifacts. Conclusion This study provides detailed predictive power for the assessability and therefore the relevance of performing cMRIs in CI patients. We advocate consulting the relevant CI center if artifact overlay exceeds 50% (categories 3 and 4), to evaluate magnet explantation and reassess the necessity of cMRI. When suspecting cholesteatoma or cholesteatoma recurrences in patients with ipsilateral cochlear implants, diagnostic investigation should preferably be pursued surgically, as the necessary MRI sequences are prone to artifact interference, even in the absence of a magnet. The ipsilateral internal auditory canal remains inadequately evaluable with a magnet in situ, while without the magnet, only rudimentary assessments can be made across most sequences.
Pubmed PDF WebF Salonna,V Foscolo,V Pontillo,V De Giglio,L Speranzon,N Quaranta,F Signorelli,D Caselli,R Messina
Publicatie 30-12-2024
Abstract Purpose Acute bacterial rhinosinusitis (ABRS) and acute otitis media (AOM) are common diseases in pediatric populations that rarely lead to intracranial infection and/or orbital complications. The incidence of these complications has increased in recent years and the main aim of this study is to analyze the tendency of this increase during the pandemic years, compared with the pre-pandemic era and to propose our management of ABRS and AOM. Method Clinical data from children, admitted to our hospital during the period from January 2018 to March 2024 with a diagnosis of complicated ABRS and AOM was collected. The sample was divided into two groups: Group A (January 2018– December 2020) and Group B (January 2021- March 2024). Results The retrospective cohort consisted of 35 patients, seven patients (20%) belong to Group A, twenty-eight patients (80%) belong to Group B. 67.9% of subjects during the COVID-19 era tested positive for SARS CoV-2 infection on average 5.5 months prior to hospital admission. Statistical analysis showed that there was a sharp increase in surgical cases of complicated AOM and complicated ABRS, after the lock-down period, compared to the previous years. Conclusion The main findings of the present study are the significant increase of complicated ABRS and AOM as well as severe complications requiring surgical treatment, after the COVID-19 pandemic.
Pubmed PDF WebOJ Ungar,H Chaushu,Y Oron,R Abu-Eta,O Handzel
Publicatie 30-12-2024
Abstract Objective To characterize middle ear (ME) effusion still present 2 months after repair surgery for spontaneous cerebrospinal fluid (CSF) leak via the temporal bone (TB). Study design A retrospective chart review (2011–2022). Setting Tertiary referral academic center. Subjects and methods All patients with persistent ME effusion at 2 months after surgery were included in this study. The indication for surgery for spontaneous TB CSF leak was an active CSF leak with tegmen dehiscence. The presence of effusion was established by findings on microscopic otoscopy aided by tympanocentesis.ME with effusion were sampled for the presence of 𝛽2transferrin. Those negative for 𝛽2transferrin had a ventilation tube placed for ME aeration of serous otitis media (SOM). Data on persistent fluid leakage from tympanostomy tubes, presence or absence of 𝛽2transferrin in the ME, and residual air-bone gap on the postoperative audiogram were recorded. Results Fifty-three ears underwent surgery to repair a CSF leak, 42 via a middle fossa craniotomy and 11 via transmastoid approaches. Fourteen ears (26%) still had ME effusion 2 months after surgery and it was sampled for 𝛽2transferrin. Seven were negative (SOM or mucoid OM) and the patients received a tympanostomy tube with resultant ME aeration and air-bone gap closure. The other seven underwent revision surgery. Conclusions Postoperative ME fluid after surgery for TB CSF leak may often represent effusion by SOM rather than an ongoing or recurrent CSF leak. ME effusion by SOM is likely caused by mucosal irritation from long-standing stagnant CSF or an underlying eustachian tube dysfunction.
Pubmed PDF WebK Chettuvatti,S Panda,R Sood,A Konkimalla,A Thakar,S Mitra,A Kumar,A Palreddy,SK Meena,CA Singh,K Sikka,R Kumar,A Singh
Publicatie 30-12-2024
Abstract Purpose Orocervical (OCF) or pharyngocutaneous fistula (PCF) are one of the disastrous complications of head and neck cancer surgery. Conventional standards of management are predominantly conservative. Though a majority of such patients respond to conservative management, it nevertheless causes significant delay in wound healing. This study explores the role of intraglandular Botulinum toxin injection in shortening the time to fistula healing. Methods Retrospective case-control study at a tertiary care oncology center in South Asia from January 2021 to December 2023 on all consecutive patients of OCF/PCF. Patients with any history of head and neck radiation were excluded. The case group received intraglandular (parotid+/-submandibular gland) botulinum toxin injection and conservative management and the control group received only conservative management. The time taken for the fistula to heal was the primary outcome. Results 31 patients in case and 104 patients were in control group. The mean time from fistula diagnosis till injection was 5.8 ± 3.1 days and the mean fistula healing time in case group was 18.5 ± 7.15 days (Range:10–34 days). The mean total dose of botulinum toxin was 59.2 ± 22.4 MU (Range: 40 to 100 MU). For control group, the mean time taken for the fistula to heal was 26 ± 15 days (Range:15 to 75 days). The difference was statistically significant (p-0.008, 95% CI: -9.0 to -2.0). Adverse effects attributable to botulinum toxin injection were: pain at the injection site (n = 3) and xerostomia (n = 1). On multivariate analysis, intervention with intraglandular botulinum toxin emerged as an independent variable impacting the time taken for fistula closure. Conclusion This is the largest study to show the efficacy of intraglandular botulinum toxin injection in reducing the time taken for healing of postoperative salivary fistula with a tolerable adverse effect profile.
Pubmed PDF WebM Maiti,M Dutta,J Datta,A Mukherjee,D Ghosh,A Mallick
Publicatie 26-12-2024
Abstract Objective Clinicopathologic illustration of sinonasal teratocarcinosarcoma (SNTCS) in a middle-aged man, highlighting the difficulties and challenges encountered during surgical intervention, histopathologic diagnosis, and its overall management. Methodology Case report and literature review. Results A 40-year-old man having recurrent epistaxis for three months presented with a dark-colored protruding polypoid nasal mass. Magnetic resonance imaging revealed a large, heterogeneous gadolinium-enhanced infiltrative lesion in the left nasal cavity with a T2-hypointense trans-septal zone. The mass abutted the cribriform plate, lamina papyracea, and septum, involved the inferior and middle turbinates, and blocked the choanae through the nasopharynx. There was profuse hemorrhage when an endoscope-assisted biopsy was attempted. Histopathology from the debulked specimen suggested SNTCS. The diagnosis was confirmed on immunohistochemistry. A metastatic search turned negative. However, at three weeks, the patient returned with a recurrence. A repeat debulking was done, and he was thereafter put on adjuvant chemotherapy. A second recurrence/residual lesion was noted midway through the chemotherapy regimen. However, it resolved after completion of the chemotherapy and subsequent image-guided radiotherapy, and the patient continued to be disease-free till the last follow-up at six weeks postradiotherapy. Conclusions SNTCS is an extremely aggressive malignancy that is seldom encountered in routine otolaryngology and pathology practice, with only a few reports of SNTCS documented. It is histologically composed of epithelial, mesenchymal, and primitive neuroectodermal elements with areas of undifferentiation. They are notorious for troublesome intra-operative bleeding, making complete surgical excision difficult, and the absence of a tumor-free margin often results in recurrence. Owing to their variegated and heterogeneous tissue composition, histopathologic diagnosis is enormously challenging without a representative tissue sample and immunohistochemistry. In spite of prompt and energetic multimodality treatment, survival rate is dismal.
Pubmed PDF WebAZ Fazilat,C Brenac,D Kawamoto-Duran,CE Berry,J Alyono,MT Chang,DT Liu,ZM Patel,S Tringali,DC Wan,M Fieux
Publicatie 26-12-2024
Abstract Purpose The artificial intelligence (AI) chatbot ChatGPT has become a major tool for generating responses in healthcare. This study assessed ChatGPT’s ability to generate French preoperative patient-facing medical information (PFI) in rhinology at a comparable level to material provided by an academic source, the French Society of Otorhinolaryngology (Société Française d’Otorhinolaryngologie et Chirurgie Cervico-Faciale, SFORL). Methods ChatGPT and SFORL French preoperative PFI in rhinology were compared by analyzing responses to 16 questions regarding common rhinology procedures: ethmoidectomy, sphenoidotomy, septoplasty, and endonasal dacryocystorhinostomy. Twenty rhinologists assessed the clarity, comprehensiveness, accuracy, and overall quality of the information, while 24 nonmedical individuals analyzed the clarity and overall quality. Six readability formulas were used to compare readability scores. Results Among rhinologists, no significant difference was found between ChatGPT and SFORL regarding clarity (7.61 ± 0.36 vs. 7.53 ± 0.28; p = 0.485), comprehensiveness (7.32 ± 0.77 vs. 7.58 ± 0.50; p = 0.872), and accuracy (inaccuracies: 60% vs. 40%; p = 0.228), respectively. Non-medical individuals scored the clarity of ChatGPT significantly higher than that of the SFORL (8.16 ± 1.16 vs. 6.32 ± 1.33; p < 0.0001). The non-medical individuals chose ChatGPT as the most informative source significantly more often than rhinologists (62.8% vs. 39.7%, p < 0.001). Conclusion ChatGPT-generated French preoperative PFI in rhinology was comparable to SFORL-provided PFI regarding clarity, comprehensiveness, accuracy, readability, and overall quality. This study highlights ChatGPT’s potential to increase accessibility to high quality PFI and suggests its use by physicians as a complement to academic resources written by learned societies such as the SFORL.
Pubmed PDF WebJ Luukkanen,T Harju,M Rautiainen,I Kivekäs
Publicatie 26-12-2024
Abstract Purpose To evaluate and compare hospital related costs, postoperative costs, and the long-term costs of maxillary balloon sinuplasty (BSP) and middle meatal antrostomy (MMA) in patients with chronic rhinosinusitis. Methods Data were collected from patient registers on 88 patients treated with BSP and 240 patients treated with MMA between 2011 and 2017. Information was also gathered on the related costs of surgery, material, postoperative ward care, and any extra patient visits that took place within one year following the operation. The costs of sick leave were estimated based on the number of sick leave days. Results The total costs of BSP (mean 3382 €, 95% CI 3157–3607) within one year after the operation were lower than those of MMA (mean 4546 €, 95% CI 4297–4796) (p < 0.001). However, the hospital related 24 h perioperative costs were higher in BSP (mean 1853 €, 95% CI 1781–1925) than in MMA (mean 1581 €, 95% CI 1515–1647) (p < 0.001). The number of sick leave days after BSP (mean 4 days) was half that of MMA (8 days) (p < 0.001), leading to an increase in sick leave costs after MMA. The duration of the BSP operation was significantly shorter than that of MMA. Conclusion BSP of the maxillary sinus ostium appears to be less expensive than MMA when the total costs are calculated one year after the operation. This information should be considered in the preoperative visit. Level of evidence 3.
Pubmed PDF WebA Ajmera,N John,A Morey,N Biggs,S Flanagan,P Earls,D Brown,P Mukherjee
Publicatie 26-12-2024
Abstract Background Meniere’s disease (MD) is a disabling disease of the inner ear, having a substantial effect on a patient’s quality of life. While various postulations regarding its aetiology exists, due to the difficulty with accessing inner ear tissue, there have been limited histological studies in patients with active MD. Methods Tissue was collected during labyrinthectomy from 8 patients with intractable MD who had failed medical therapy (22 samples), and 9 patients undergoing translabyrinthine resection of vestibular schwannoma (19 samples). 20 additional samples were obtained from 2 cadavers without a history of inner ear disease. Samples were assessed with routine histology and a panel of immunohistochemical markers to assess any differences between the groups. Results No MD samples demonstrated significant inflammatory infiltrate, evidence of denervation of the sensory epithelium, fibrosis, or thickening of blood vessel wall stroma. Novel findings included confirmation that no lymphatic channels of usual type were present and that the subepithelial stromal cells are strongly positive for S100, suggesting possible perineurial origin. There were no consistent differences in expression of Claudin or Aquaporin between the MD and VS patient samples. Conclusion This is one of the largest comparative histological study utilising operative samples from inner ear of living donors with active intractable MD and control patients with VS. There were no significant morphological differences between the two groups, suggesting that the aetiology lies elsewhere within the vestibular system. Examination of endolymphatic sac tissue is therefore a priority for future work.
Pubmed PDF WebM Sevilla-Ayensa,A Pérez-Arruti,M Alberich-Inchausti,E Larruscain-Sarasola,JA González-García,JA Sistaga-Suarez,CM Chiesa-Estomba
Publicatie 26-12-2024
Abstract Purpose Head and neck cancer (HNC) remains a significant global health concern with rising incidence and substantial impacts on patients’ quality of life. Patients often experience adverse effects from both the disease and its treatment, affecting daily functions and social interactions. This study assesses the usability, interest, and satisfaction of HNC patients in using Step Oncology® platform for improved treatment adherence and quality of life. Methods A unicentric observational study was conducted at Donostia University Hospital involving 20 HNC patients, using Step Oncology® platform The Step Oncology® platform, an AI-powered, patient-centered tool, aims to support personalized patient care through real-world data, enhancing decision-making and symptom management. Usability was evaluated using guided scenarios and the System Usability Scale (SUS). Patients completed tasks such as symptom reporting, questionnaire access, and symptom history review. Qualitative data were collected via the “Think Aloud” method, while satisfaction and interest were measured through questionnaires. Results Participants successfully completed 93.75% of tasks, with challenges primarily in accessing instructions. SUS scores averaged 87.9, indicating high usability, with no significant differences based on age or technology familiarity. 90% expressed interest in continued use, and satisfaction was rated as “Excellent” or “Good” by all participants. Conclusion Step Oncology® demonstrated high usability, satisfaction, and acceptance among HNC patients, supporting its feasibility in clinical practice. Future work includes expanding this study for broader validation and assessing the platform’s long-term impact on patient adherence and outcomes in routine care.
Pubmed PDF WebR Arora,J Singh,D Rawal,M Barkhane,A Goyal
Publicatie 24-12-2024
Abstract Objective To ascertain the feasibility of simultaneous bilateral same-day endoscopic tympanoplasty in a secondary-level hospital in a developing country. Material & methods A prospective interventional cohort study conducted at a secondary-care hospital in North India. Inclusion criteria: Consenting patients having bilateral perforations aged 10–50 years. Exclusion criteria: Cholesteatoma/granulations/need for ossiculoplasty/previously operated ear/s. Temporalis fascia graft sufficient to repair 2 perforations was harvested from a right-side supratemporal incision followed by endoscopic trans-canal underlay tympanoplasty on both ears in the same session. Follow-up: 7th day and 1, 3, and 6 months post-operatively. An intact graft at 6 months was considered surgical success. Hearing improvement was assessed by pure tone audiometry done 6 months postoperatively. Results 20 patients (40 ears) had large central/subtotal perforations. 38 out of 40 ears had successful graft uptake at 6 months. Average preoperative and postoperative air-bone gaps were 31+-4.4, 16.6+-2.9 dB respectively (p < 0.001, significant). Average air-bone gap closure was14.5+-3.2 dB. There was no instance of postoperative sensorineural hearing loss/postoperative complications. Conclusion Bilateral same-day endoscopic tympanoplasty is feasible, safe, and efficient, saving time and resources for both the healthcare system and patients.
Pubmed PDF WebH Lin,H Chi,K Xu
Publicatie 24-12-2024
A Sathish Kumar,W Ahmad,A Irfan,S Rath
Publicatie 24-12-2024
SSS Badrol,O Ziv,C Peled
Publicatie 24-12-2024
Abstract Purpose Necrotizing otitis externa (NOE) is a serious life-threatening infection, with Pseudomonas (PA) aeruginosa being the primary causative agent. Over the last two decades the use of systemic anti-PA antibiotics expanded substantially and are now prescribed regularly by physicians. Meanwhile, studies indicate shifting trends in the incidence of the offending pathogen in NOE. The objective of the study is to assess whether preadmission antibiotic treatment influence the incidence offending pathogens and sterile cultures in NOE. Also, we aim to evaluate the effects of preadmission antibiotic treatment on NOE severity and disease progression. Methods A retrospective case series analysis was performed, including all patients admitted in a single tertiary center due to NOE. Results 83 patients were included in the study. Among them 17 patients received no oral antibiotics prior to admission (NoAb-NOE), and 65 patients received systemic antibiotics prior to admission. There was no statistical difference between the groups regarding the incidence of the pathogen or sterile culture. Furthermore, there was no statistical difference regarding duration of hospitalization, need for surgery or readmission. Conclusion Preadmission antibiotic treatment does not influence the incidence of offending pathogens or rate of sterile culture in NOE. Moreso, preadmission antibiotic has no effect on disease progression or severity in NOE. Our findings suggest that sterile culture NOE is probably due to the low sensitivity of superficial swabs and not secondary to partially treated disease. Deep tissue culture should be considered in the setting of NOE patients.
Pubmed PDF WebG Gravante,AD Arosio,N Curti,R Biondi,L Berardi,A Gandolfi,M Turri-Zanoni,P Castelnuovo,D Remondini,M Bignami
Publicatie 24-12-2024
Abstract Background Artificial intelligence (AI) demonstrates high potential when applied to radiomic analysis of magnetic resonance imaging (MRI) to discriminate sinonasal tumors. This can enhance diagnostic suspicion beyond visual assessment alone and prior to biopsy, leading to expedite the diagnostic timeline and the treatment planning. The aim of the present work is to evaluate the current advancements and accuracy of this technology in this domain. Methods A systematic literature review was conducted following PRISMA guidelines. Inclusion criteria comprised studies utilizing any machine learning approach applied to MRI of patients with sinonasal tumors. For each study, comprehensive data were gathered on the MRI protocols, feature extraction techniques, and classifiers employed to develop the AI model. The performance was assessed based on accuracy and area under the curve (AUC). Results Fourteen studies, published between May 2017 and August 2024, were included. These studies were categorized into three groups: those examining both benign and malignant tumors, those investigating malignant tumor subpopulations, and those focusing on benign pathologies. All studies reported an AUC greater than 0.800, achieving AUC > 0.89 and accuracy > 0.81 when incorporating clinical-radiological variables. Notably, the best discrimination performance was observed in studies utilizing combined conventional MRI sequences, including T1-weighted, contrasted T1-weighted, and T2-weighted images. Conclusion The application of AI and radiomics in analyzing MRI scans presents significant promise for improving the discrimination of sinonasal tumors. Integrating clinical and radiological indicators enhances model performance, suggesting that future research should focus on larger patient cohorts and diverse AI methodologies to refine diagnostic accuracy and clinical utility.
Pubmed PDF WebJR Lechien,CM Chiesa-Estomba,S Hans,A Nacci,A Schindler,JE Bohlender,D Runggaldier,L Crevier-Buchman,H Oguz,K Zelenik,M Tedla,N Siupsinskiene,J Schlömicher-Thier,R Taimrova,PD Karkos,A Geneid,G Dapri,J Aoun,V Muls,M Weitzendorfer,EV Savarino,MJ Remacle,M Sereg-Bahar,M Mayo-Yanez,G Iannella,AM Saibene,LA Vaira,G Cammaroto,A Maniaci,MR Barillari
Publicatie 24-12-2024
Abstract Objective To propose a European consensus for managing and treating laryngopharyngeal reflux disease (LPRD) to guide primary care and specialist physicians. Methods Twenty-three European experts (otolaryngologists, gastroenterologists, surgeons) participated in a modified Delphi process to revise 38 statements about the definition, clinical management, and treatment of LPRD. Three voting rounds were conducted on a 5-point scale and a consensus was defined a priori as agreement by 80% of the experts. Results After the third round, 36 statements composed the first European Consensus Report on the definition, diagnosis, and treatment of LPRD. The hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring is the gold standard for diagnosing LPRD (> 1 pharyngeal reflux event) and treating the LPRD with personalized therapy. The empirical treatment needs to be based on diet, stress reduction, and alginates or antiacids to address the acidic and alkaline reflux events. Proton pump inhibitors are kept for patients with acidic LPRD and gastroesophageal reflux disease (GERD) findings. The treatment needs to be as short as possible (minimum two months). The medication can be progressively reduced for patients with relief of symptoms. Changing medication class can be considered for refractory LPRD rather than an increase in drug doses. Conclusion A consensus endorsed by the Confederation of European Otorhinolaryngology-Head and Neck Surgery Societies is presented to improve the management and treatment of LPRD. The approved statements could improve collaborative research through the adoption of common management approaches to LPRD.
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